School of Public Health - International Health
Togo - Supporting improved HIV treatment outcomes among men who have sex with men and female sex workers living with HIV in Togo
This partnership would be completed together with FHI 360 funded by the United States Agency for International Development West Africa Mission (USAID/WA). The work in Togo would be part of a regional project which would also include engagement in Burkina Faso focused on building government political will and resources to engage key stakeholders to support programs that are evidence-based, adaptable, replicable and transferrable throughout the region.
Our team has been supported through CCP and USAID WA to support PACTE-VIH to build its research agenda through high quality implementation research studies. This relationship is built on a consortium of partners working towards achieving common goals.
This position would support the development of the following aims:
- Support the measurement of the HIV Cascade among Key Populations in Togo.
-Help develop a passive data collection approach to characterize the HIV treatment cascade specifically among key populations in partnership with the Government of Togo and PACTE VIH
-Implement intervention to support retention in the HIV cascade, through training mediators in HIV treatment retention support
-Support the evaluation of intervention benefit through the use of the aforementioned passive data collection system on people living with HIV.
Global Health PI/Mentor: Stefan Baral
The grant from GHEFP allowed me the opportunity to work with the Center for Public Health and Human Rights at JHSPH for five incredible months working in Togo and Benin. I worked very closely with Arc-en-ciel, a local NGO that provides healthcare and HIV/STI testing services in Lomé and serves as the research partner for the two projects for which I provided support during my time in Togo and Benin. The team welcomed me from the very beginning, gave great advice, and were the people from whom I learned more than I could have thought possible while in the region. Not only did I gain professional skills during my placement, but my colleagues also taught me about the culture of the country and the city, how to prepare akoumé passably well, and even how to dance (the last of which usually involved ten minutes of raucous laughter and at least one cell phone recording of my ineptitude for posterity).
For the first of the two projects, I supported the development of a baseline assessment of the human rights-related barriers to access, uptake and retention in HIV services among key and vulnerable populations in Benin. This assessment was drafted for the Global Fund as a foundation to inform the scale-up of HIV-related programming for key and vulnerable populations in the country. While in-country, I coordinated data collection and synthesized qualitative data to compose a baseline for the Global Fund describing the human-rights related barriers to HIV services and existing interventions. Along with the team, I coordinated with partners in Benin to conduct in-depth interviews with key informants and focus group discussions with members of key populations, including men who have sex with men, female sex workers, individuals with physical handicaps, women who have sex with women, people who inject drugs, men and women living with HIV, truck drivers, current and former prisoners, and women who work in bars and restaurants. Both during my time in the region and for several months afterward, I synthesized the qualitative data and results of the desk review to develop a report describing the current barriers and existing interventions and developed a proposal for a comprehensive approach to be scaled up the country.
For the second the two projects, I coordinated study activities and provided technical support for a longitudinal study looking at the effectiveness of the individualized case management approach in optimizing sustained viral load suppression and improving retention in care among men who have sex with men and female sex workers living with HIV in Lomé, Togo, as compared to the standard of care. My role on the project included working with partner NGOs on data collection processes and conducting interim data analyses. I developed a presentation of these interim results that were presented to a meeting of more that 50 local and national stakeholders in Togo. In addition to working on the quantitative piece of the study, also contributed to the development of qualitative data collection tools and translated technical and program documents between English and French.
Working on this study demonstrated to me the importance of developing strong connections with staff, mediators, and interviewers in the field and to ensure that they are an integral part of the data collection process and have a firm understanding of the objectives and background of the project. Additionally, working with the team in Lomé taught me how different the conditions in the field can be as compared to the conditions that may be envisioned when planning a project, highlighting the importance of adaptive learning and project management. For example, political unrest presented ongoing issues during my time in Lomé, which often influenced timelines, scheduling, and overall workflow. Developing an adaptable and flexible approach was extremely important throughout the entire experience.