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The HIV counseling and voluntary testing strategy is starting to bear fruit in the historic center of Quito, Ecuador’s capital city, where last year the number of tests conducted doubled and timely linkage and treatment for HIV-positive people was achieved.
By: Guido Vinicio Cisneros Sierra
Aware of the seriousness of Ecuador’s HIV epidemic and particularly in the historic center of Quito–a tourist area with multiple hotspots for sex work offered by men, women and trans people–authorities of the Unidad Metropolitana de Salud Centro (Metropolitan Health Unit of the Historic Center of Quito or UMSC) considered it necessary to apply new strategies to connect people to combination prevention. It has been proposed to extend Counseling for Voluntary HIV Testing aimed at people at large, with emphasis on most-at-risk populations, which includes men who have sex with men, as well as male and female sex workers.
Significant achievements have been possible thanks to this strategy of offering rapid HIV testing to all users of this Health Unit. The number of HIV tests conducted has doubled compared to 2017, with a total of 1,120 tests, of which 662 were conducted at the request of users, 328 were conducted on men, 334 on women, 159 on LGBTI people and 23 on trans women.
It is important to point out that this has also been possible thanks to the quality of care offered to key populations. Users from the LGBTI community receive preferential care, they do not have to schedule an appointment through the call center. Right after they are tested for HIV, they go to the Statistics Division so that their medical record is opened, and an appointment is booked for that same day. With these changes in the service provided and the use of rapid tests, more users of that community are coming to the health center, which consolidates it as an inclusive health care center emphasizing quality and warm services for the LGBTI community.
Of all tests conducted, 10 new cases were identified in men who have sex with men, 1 case in a trans woman and 1 case in a man of the general population. All results were confirmed and then they were referred to the Comprehensive Care Units for People with HIV of hospitals located in Quito. All of them are currently receiving treatment.
Tests on Pregnant Women
Rapid tests are also offered to pregnant women. In 2018, 299 rapid HIV tests were conducted in the Health Unit of the Historic Center of Quito, and no one tested positive.
Conducting tests on pregnant women has also allowed to reach a larger number of men, as the Free Maternity Act of Ecuador’s Ministry of Public Health has been applied, which seeks to reach couples and offer them rapid HIV testing.
A Strategy that Works
In Quito, Counseling for Voluntary HIV Testing is yielding positive results and is becoming a secondary prevention tool that helps diagnose new infection cases, link them to health care units aimed at people with HIV and ensure treatment for them.
It has also contributed to consolidate evidence regarding the population groups in which this epidemic is concentrated–gay people, other men who have sex with men and trans women.
This strategy aims at achieving the 90-90-90 target by 2030. Actions have been possible within the framework of an agreement between Corporación Kimirina and the Health Secretariat of the Metropolitan District of Quito (a signatory city of the Paris Declaration to end the AIDS epidemic), with funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria.
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