USAID SHIFT-supported Sites Ensure Treatment Quality through Routine Viral Load Testing

7/26/2019 - Over the last year, USAID Sustainable HIV Response from Technical Assistance (USAID SHIFT)-supported sites provided routine viral load testing to 83.3 percent of eligible patients (25,045), 97.8 percent had a suppressed viral load (<1,000 copies/mL) and 97 percent had an undetectable viral load (<200 copies/mL). The project leveraged generous support from the Global Fund, coordinated by the Vietnam Administration of HIV/AIDS control, to fund tests despite social health insurance delays. So What? Comprehensive patient management requires yearly viral load testing to measure the appropriateness of antiretroviral regimens and the patient’s risk of transmitting HIV to others.

USAID SHIFT Supports Sites to Increase Case Finding and Treatment Initiation in Hanoi in Q3

7/12/2019 - In quarter 2 (Q2), USAID SHIFT-supported sites in Hanoi missed critical case-finding and new HIV treatment initiation targets, leading the project to launch an intensified case-finding strategy at the start of May. Through a diversified outreach approach and updated incentives, the project increased case-finding results in Q3 by 2.4 times compared to Q2 (Q2: 56 individuals, Q3: 134 individuals) and increased new treatment initiation results in Q3 by 1.8 times compared to Q2 (Q2: 167 individuals, Q3: 306 individuals). So What? These intensified efforts have accelerated Hanoi’s progress towards the first two UNAIDS Fast-Track Targets, whereby 90% of people living with HIV know their status, 90% of those individuals are sustained on treatment, and 90% of PLHIV are virally suppressed.

USAID SHIFT Successfully Links 95% of all New HIV Cases to Treatment in Hanoi

6/21/2019 - USAID SHIFT supports treatment enrollment through technical assistance and by paying performance-based incentives only after newly identified HIV positive clients enroll in antiretroviral therapy (ART). To date this quarter (12/13 weeks Q3), 95% (115/121) of all HIV positive cases identified by the project enrolled in ART at USAID SHIFT-supported sites. Several others enrolled at different facilities or deferred treatment initiation based on underlying clinical factors and plan to enroll soon. So What? The sooner a patient begins ART, the sooner they begin reducing their viral load which improves their personal health outcomes and helps prevent transmission of HIV to others.

USAID SHIFT Utilizes Online Channels to Reach and Connect MSM to HIV Testing

6/14/2019 - USAID SHIFT is expanding its online-to-offline strategies to reach men-who-have-sex-with-men (MSM) missed by more traditional approaches. Through ads and broadcast messages linked to an online risk assessment as well as counselors hosted on dating apps popular among MSM, online outreach activities in Hanoi have identified four new HIV cases in the past two weeks and linked all of them to treatment. So What? Online outreach provides an opportunity to connect with hidden MSM, supporting them in assessing their risk online and connecting to testing, while respecting the confidentiality and anonymity many require.

USAID SHIFT Partners with Provincial Leaders to Launch Acceleration Strategy in Dong Nai

6/10/2019 -In late April, USAID SHIFT launched the Hanoi case-finding acceleration plan which drastically improved case finding and treatment enrollment results in May. This week, USAID SHIFT met with the Dong Nai Department of Health, leaders from hospitals and district health centers in Dong Nai to launch four surge modalities and site action teams to address the province’s poor progress towards case finding and treatment enrollment targets. So What? While each province has unique challenges, lessons learned from the Hanoi surge can inform a streamlined strategy in Dong Nai to identify more people with HIV and link them to treatment.

USAID SHIFT’s Acceleration Strategy Successfully Scales Case Finding in Hanoi 636%

6/3/2019 - USAID SHIFT developed and launched an intensive case-finding strategy four weeks ago to increase the total number of people who test positive for HIV and enroll in treatment at the project’s seven sites in Hanoi. This strategy, which added new case-finding modalities and involved working with sites to improve performance,  has increased identification of HIV positive cases by 636% (70 vs 11) and enrollment in treatment by 254% (145 vs 57) over last month. So What? Case-finding has traditionally been challenging in Hanoi, but diversifying outreach strategies has reached new individuals and linked those positive to life-sustaining treatment.

Micro-Epidemic Control Model Supports Case Finding in Hanoi

5/27/2019 - By combining patient-centered index testing with improved testing technology, USAID SHIFT’s micro-epidemic control model is supporting enhanced case finding in Hanoi. For example, this week Tay Ho District Health Center retested the sexual partner of a person living with HIV using the Alere HIV Combo test (available thanks to advocacy from USAID and USAID Healthy Markets), confirmed her as HIV positive using PCR DNA (available thanks to advocacy from USAID and USAID SHIFT) and linked her to treatment. Previous HIV screening tests at various locations had proved inconclusive and the client had not been offered advanced PCR DNA confirmatory testing before. So What? Intensive case-finding requires sites and implementers to focus on the needs of each individual, leverage the best tests possible, and link all positive cases to treatment to broaden the reach and impact of case-finding efforts.

Hanoi Case Finding Surge Drives HIV+ Case Finding in Early May

5/13/2019 - USAID SHIFT’s case finding surge strategy led to the confirmation of 16 cases that screened positive for HIV last week (eight cases confirmed last week and eight cases confirmed on Monday, May 13) in Hanoi. The project’s ability to increase case finding from an average of less than four cases each week in April to 16 in little more than a week is an early indication that the surge modalities are driving results. So what? HIV case identification and quick connection to treatment have historically been challenging in Hanoi, but creative, diversified outreach strategies to reach, test and connect cases to ART are essential to achieve epidemic control.

USAID SHIFT ‘s Newly Revamped Reach 4.0 Risk Assessment Launches

5/5/2019 - On April 27, USAID SHIFT launched online advertisements in Hanoi to drive traffic to its newly revamped Reach 4.0 online risk assessment and appointment scheduler. In just six days, 182 individuals that completed the assessment were identified as being at high risk of HIV, 75 registered for testing (facility, lay or self-testing) and more than 20 people living with HIV (PLHIV) not currently in treatment were identified for follow-up. So What? Online outreach is critical to connecting with hidden and under-reached key populations and is a core component of USAID SHIFT’s current case-finding acceleration plan aimed at increasing testing and linkages to treatment for PLHIV in Hanoi.

Photo: Landing page for new Reach 4.0 risk assessment

Photo: Landing page for new Reach 4.0 risk assessment

USAID SHIFT Launches Case Finding Action Teams in Hanoi

28/4/2019 - As results for Q2 in Hanoi were finalized this week, USAID SHIFT launched three cross-technical action teams to identify root causes of poor case finding performance and implement improvements at each project-supported site in Hanoi. Already, these action teams have contacted all seven SHIFT-supported sites (and conducted three intensive site visits) to coach them on improving client-centered, key population-friendly services while also providing technical assistance to improve index testing services. USAID SHIFT’s cross-technical teams are able to bring their diverse expertise to evaluate each site’s performance holistically while developing innovative solutions to improve Hanoi’s progress towards ensuring 90% PLHIV know their status, a key milestone in epidemic control.

Provincial Authorities Pledge Nearly $38,000 To HIV Prevention in Dong Nai and Tien Giang

19/4/2019 - In March, Dong Nai pledged VND 750 million (US $32,300) and Tien Giang pledged VND 126 million ($5,430) for fiscal year 2019 to support HIV prevention and case finding activities through financial stipends and performance-based incentives for community-based supporters in districts and communes that do not currently receive international donor support for this work. USAID SHIFT provided technical assistance to provincial leaders as they worked to allocate resources towards populations at increased risk for HIV and will continue to work with leaders to ensure appropriate targeting of funds as the HIV epidemic evolves. As international donors reduce funding for these areas, substantive, adaptive domestic financing for HIV prevention and case finding activities will serve as the backbone of efforts to prevent HIV transmission and diagnose 95% of all people living with HIV, both key to achieving HIV epidemic control.

Local Health Authorities in Tay Ninh and Tien Giang Improve Accuracy of National HIV Database

12/4/2019 - As newly-supported provinces, USAID SHIFT provided comprehensive technical assistance to Tien Giang and Tay Ninh from Summer 2018 through March 2019 to verify all HIV cases logged in HIVInfo. During the months-long process, local health authorities in both provinces reviewed every person living with HIV (PLHIV) in the system and confirmed mortality, treatment and residency status, eventually recommending records for removal (a total PLHIV case reduction of 17.5% in Tay Ninh and 10.6% in Tien Giang) from HIVInfo. Case verification activities ensure the accuracy of provincial data and support the appropriate allocation of project and government resources for HIV services.

USAID-SHIFT-Supported Sites Successfully Rollout SHI-for-ARVs

5/4/2019 - Four weeks after the launch of social health insurance (SHI) reimbursement for antiretrovirals (ARVs) in Vietnam, five USAID SHIFT-supported sites have already claimed $13,000 in reimbursements for 2,140 patients (58,005 pills). Prior to the March 8 launch and during the first weeks of implementation, USAID SHIFT provided comprehensive technical assistance to ensure patients, doctors, and pharmacists successfully prescribed, dispensed and tracked ARVs purchased using SHI. The successful scaling of SHI for ARVs nationally, including at USAID SHIFT supported sites, is critical to the long-term sustainability of HIV interventions as international donors reallocate HIV resources to other countries.

Photo: A pharmacist at Quang Ninh General Hospital prepares antiretrovirals for patients using social health insurance

Photo: A pharmacist at Quang Ninh General Hospital prepares antiretrovirals for patients using social health insurance

USAID SHIFT Responds to More Than 100 TA Requests

29/03/2019 - The USAID SHIFT program operates the Technical Assistance (TA) Marketplace where local HIV stakeholders can access information about pre-qualified TA providers with expertise in diverse domains. Since its launch in October 2016, USAID SHIFT has fulfilled more than 100 TA requests using providers listed on the TA Marketplace. This unique platform is promoting a sustainable HIV response by centralizing information about qualified TA providers available to be matched with those in need of technical support.

Photo: Screenshot of online portal for USAID SHIFT TA Marketplace (   www.TAMarketplace.org   )

Photo: Screenshot of online portal for USAID SHIFT TA Marketplace (www.TAMarketplace.org)

USAID SHIFT Capacitates Government Clinics to Retain HIV Patients in Treatment

25/03/2019 - Attrition is a serious threat to the effectiveness and sustainability of a country’s HIV response; when the quality of HIV treatment services are poor, patients may not adhere to treatment regimens, miss scheduled clinic visits, fail to pick up medications, and even die prematurely due to complications from the AIDS virus. In the first quarter of fiscal year 2019, the USAID SHIFT program coached and supported 31 government clinics to reduce HIV patient attrition by 32%. So what? Through the program’s Enhanced Antiretroviral Therapy (ART) Retention Intervention, USAID SHIFT is ensuring that government clinics deliver high-quality services to track and retain patients and reduce efforts required to reengage lost patients.

Photo: Screenshot from USAID SHIFT Attrition Data Dashboard

Photo: Screenshot from USAID SHIFT Attrition Data Dashboard

National Dashboard to Track SHI-Covered ARVs Launched with Technical Assistance from USAID SHIFT

15/03/2019 - Building on last week’s initiation of social health insurance (SHI)-covered antiretrovirals (ARVs), this week the Vietnam Administration of HIV/AIDS Control (VAAC) and Vietnam Social Security Agency (VSS) launched a national dashboard to track uptake of SHI for ARVs. The dashboard launch is the culmination of a year-long advocacy and technical assistance effort from USAID SHIFT, which, after just four working days, has already tracked 1,339 patients from 25 provinces as receiving SHI-covered ARVs. So What? This dashboard will ensure VAAC, VSS, and international donors are able to monitor the transition from donor-supported to SHI-covered ARV drugs and quickly address issues to ensure patients do not experience interruptions to their antiretroviral therapy.

Photo: Map automatically generated by dashboard system tracking national uptake of SHI-covered ARVs as of March 13, 2019

Photo: Map automatically generated by dashboard system tracking national uptake of SHI-covered ARVs as of March 13, 2019

USAID SHIFT Coordinates National SHI for ARV Event Headlined by Minister of Health and US Ambassador

08/03/2019 - US Ambassador Daniel Kritenbrink and Vietnam’s Minister of Health led a national celebration of the country’s first HIV patients to receive treatment medicines through social health insurance (SHI). The event was hosted from Nam Tu Liem District Health Center in Hanoi, where the USAID SHIFT program has helped see that more than 90% of HIV patients have valid SHI cards. So What? SHI-covered drugs will ensure that HIV patients in Vietnam can stay on treatment while USAID and PEPFAR reallocate resources.  

Photo 1: US Ambassador Daniel Kritenbrink speaks to the crowd on March 8 and congratulates Vietnam on efforts to sustain HIV services despite international funding reductions

Photo 1: US Ambassador Daniel Kritenbrink speaks to the crowd on March 8 and congratulates Vietnam on efforts to sustain HIV services despite international funding reductions

Photo 2: Minister of Health Nguyen Thi Kim Tien speaks to the crowd on March 8 and underscores the Government of Vietnam’s commitment to the use of SHI for ARVs

Photo 2: Minister of Health Nguyen Thi Kim Tien speaks to the crowd on March 8 and underscores the Government of Vietnam’s commitment to the use of SHI for ARVs

USAID SHIFT Helps Integrate Information Systems for Government HIV Treatment Sites

01/03/2019 - The USAID SHIFT program is helping Government of Vietnam health facilities to integrate HIV into their information systems, allowing for streamlined HIV patient management, program reporting, and social health insurance tracking. After completing integration for 21 sites in FY17-18, in the first quarter of FY19 the program began assisting 10 additional large, government-operated HIV treatment facilities in six provinces to integrate HIV in to their native data platforms. Such health informatics work is vital to promoting a locally-sustainable HIV response, as integrated health information systems improve service efficiency and tracking from site to national level.  

A clinician uses integrated health information system to review information on her patients’ treatment services and outcomes.

A clinician uses integrated health information system to review information on her patients’ treatment services and outcomes.

USAID SHIFT and Government of Vietnam Enable 97.7% of HIV Patients to Achieve Viral Suppression

25 February 2019 - When HIV patients’ treatment is highly effective, the amount of virus circulating in their systems dramatically declines, improving their health outcomes while reducing their risk of transmission. Over the last year, the USAID SHIFT program has helped Government of Vietnam clinics measure the HIV viral loads of 20,946 eligible patients, of whom 97.7% had suppressed viral loads (less than 1,000 copies of HIV viral RNA per milliliter of blood, or <1,000 cp/mL) and 96.8% had undetectable viral loads (<200 cp/mL). These results indicate superb treatment quality and adherence, helping to control the HIV epidemic while improving HIV patients’ prospects for healthy lives.  

Treatment provider counseling an HIV patient on his viral load testing results

Treatment provider counseling an HIV patient on his viral load testing results

Screenshot of USAID SHIFT Viral Load Data Dashboard

Screenshot of USAID SHIFT Viral Load Data Dashboard

USAID SHIFT-Supported Sites Exceed HIV Case-Finding Targets

18 February 2019 - Between October and December of 2018, the USAID SHIFT program assisted government and affiliated community sites to provide HIV testing, counseling and results to 14,446 at-risk individuals. Of these, 1,039 – or 7.2% – were confirmed HIV-positive and supported to access treatment. Thanks to comprehensive capacity building and support from USAID SHIFT, sites in six high-priority provinces are far exceeding their HIV case-finding aims while taking increasing ownership for the HIV response.