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(Note: Please download the “General Guidelines to submit Expression of Interest (EOI) For Service Delivery of HIV Testing & Prevention among MSMs/TGs/FSWs in Pakistan” by clicking on download)

TERMS of REFERENCE for Community Based Organizations

HIVAIDS PREVENTION SERVICES for KEY POPULATIONS {Female Sex Workers (FSW), Male Sex Workers/ Men who have Sex with Men (MSW/MSM), Transgenders/Transgender Sex Workers (TG/TGSW)

Background: Pakistan is currently facing concentrated HIV epidemic that is silently spilling over into the general population through bridging populations. Recent epidemiological evidence (IBBS-2016) has indicated that HIV prevalence has plateaued in people who inject drugs (PWID) but an alarming rise in HIV prevalence in sexual networks. IBBS-2016 has indicated a rise in HIV prevalence among key populations in various cities across the country and recently concluded surveillance round (IBBS-2016 vs IBBS-2011) reported an increase in HIV prevalence in all key populations: People who inject drugs (PWID) from 37.8% to 38.4%, male sex workers (MSW) from 3.1% to 5.2%, female sex workers (FSW) from 0.8% to 2.2% and in Transgenders sex workers (TG-SW) from 7.2% to 7.5%.

Introduction: Keeping in view the increased trends of HIV epidemic in Key Populations, National AIDS Control, Principle Recipient (PR) of the Global Fund grant (GFATM-NFR-2018-20), has introduced an innovative prevention model to provide a key population specific defined package of services to the respective key populations. For the purpose. \Greenstar has been selected as Sub recipient to implement the HIV Prevention Community based Model in the Country. The model is aimed at scaling-up HIV testing and prevention services, improving program coverage and addressing stigma and discrimination associated with these key populations and HIV/AIDS.

Purpose of the Assignment:

It aims to provide prevention services to the key population specific prioritized cities and ensure coverage of 32,962 MSM/MSW, 7,514 TG/TGSW and 4,932 FSW based on the high impact scenario and IBBS-2016 mapping by 31^st December, 2020. The ultimate goal is reduction in new infections in these key populations, reduced transmission to spouses/intimate contacts, and a decline in HIV associated morbidities and AIDS related deaths.

Objectives. The core objective of this contract is to control and prevent the spread of HIV/AIDS among the key populations by increasing the uptake of HIV testing and prevention services, efficient linkages/referral mechanisms for timely initiation of anti-retroviral treatment and ensuring treatment adherence. Key population specific defined packages of services are to be provided to the respective key populations operating in all the KP-specific hotspots as identified in the IBBS-2016 mapping exercise

Essential Criteria:

1. The potential CBO must be registered in Pakistan
2. Must have registered at least 50 any of the above mentioned key populations for preventive/treatment services
3. Must have established set up in the district applying for the key population
4. A CBO can apply for different district/cities, but only for one key population

Specific Criteria:

1. One page note on understanding of implementation/methodology of service packages for the KP applying for
2. CVs of staff who will be engaged for the project, staff from key populations will be preferred
3. Two page brief profile of the CBO

Duration & Geographical Coverage of the project: These prevention services will cover Punjab and Sindh provinces as detail given below;

The project will have a duration from 1st August 2018 till 31 December 2020 and the selected CBO will be providing the following services

The selected CBO will be providing the following services

1. Provide safe and community acceptable drop-in centres at which awareness, training, counselling and interactive activities will take place on a regular basis.
2. Promote and increase the use of safer sex practices including condom use and improved health care seeking behaviour through behaviour change interventions implemented through peer outreach programs.
3. Provide a selected set of basic health care and STI services based on syndromic approach using updated National STI Guidelines.
4. Promote an enabling environment to support project implementation.
5. Provide education on sexual and reproductive health including sexually transmitted infections (STIs).
6. Psycho social counselling
7. Main focus on linking PLHIVs to the ART Centres and encourage partner/spouse HIV/STI testing, prevention and treatment

Defined prevention services package for MSM/MSW/TG/TGSW:

• Behavioral change communication through outreach (includes Condom & Lubes, IEC material)
• Drop-In Center facility (for repeat BCC /Psycho social support & Counselling)
• VCCT with pre/post counselling & psychological counselling (community-based HIV testing)
• STI diagnosis & Treatment
• Referral support to PLHIV clients with strong follow-up
• Condoms & lubes distribution and
• Career counselling and family counselling in DIC

Defined prevention services package for FSWs:

• Establishment of Drop-In Centers (DIC) to deliver services to FSWs;
  • Screening/testing of HIV
  • Syndromic Management of STIs;
• Community based outreach through peer educators for behavior change;
• Establish condom distribution network to enhance safe sex practices
• Promotion of an enabling environment in the project area;

Assigned targets according to the Performance Framework

All Selected CBOs will be assigned targets according to the performance framework provided by GF, the targets will be assigned against the following key components

• Number of MSM/TG or FSW reached through community based HIV prevention outreach program in Pakistan (Behaviour Change Communication – BCC)
• Number of MSM/TG or FSW who received an HIV test through project CBOs and who know their results in Pakistan (Volunteer Counseling & Testing – VCT)
• Cases of sexually transmitted infections treated through project CBOs amongst MSM /TG or FSW in Pakistan (Sexually Transmitted Infections – STIs)
• Distribution of Condoms & Lubricants among key community members

Acronyms

• BCC – Behaviour Change Communication
• NACP – National AIDS Control Program
• GS – Greenstar
• PR – Principal Recipient
• SR – Sub Recipient
• MSM - Males who do sex with Males
• MSW - Male Sex Worker
• TG - Transgender 
• TGSW- A Transgender Sex Worker
• FSW- Female Sex worker
• STIs – Sexually Transmitted Infections