DHHS-CGH: Implementing Evidence-Based Prevention Interventions for Key and Priority Populations in the Republic of Rwanda under the PEPFAR

Deadline: 8 October 2018

The Department of Health and Human Services, Centers for Disease Control is seeking applications for “Implementing Evidence-Based Prevention Interventions for Key and Priority Populations in the Republic of Rwanda under the President’s Emergency Plan for AIDS Relief (PEPFAR)” to build on the previous work in implementing evidence-based interventions for HIV prevention, care, and treatment among key populations (KP) and priority populations (PP) in Rwanda including male and female commercial sexual workers (CSWs), men who have sex with men (MSM), and other high-risk individuals.

This NOFO will continue to support the needs of the Rwanda HIV Plan 2018-2020.The focus will be on provision of a comprehensive package of prevention services including HIV counselling and testing including index testing, same day linkage to treatment, voluntary medical male circumcision (VMMC), adherence and retention support, and follow-up of HIV- negative KPs and PPs. A monitoring and evaluation (M&E) component will include mapping and MSM and female sex workers (FSW) size estimates and Biological and Behavioral Surveillance Surveys (BBSS), data collection support, and analysis of program data to inform evidence-based decision making to improve the HIV prevention program for KP and PPs in Rwanda.

Program Outcomes

Strategy 1: Develop, implement, and coordinate effective case findings, high-yield testing modalities, and linkage strategies for KP/PP
- Short-Term Outcomes:
  - Improved targeted testing of KP/PP through optimization of HIV testing modalities
  - Increased linkage to treatment of HIV positive KP/PP
  - Increased retention in HIV treatment
  - Increased linkage of HIV negative KP/PP to prevention services
- Intermediate Outcomes:
  - Increased HIV case identification through targeted testing for KP/PP
  - Increased VLS among KP/PP
  - Increased uptake of HIV prevention and treatment services among KP due to effective linkages
Strategy 2: Develop and implement a comprehensive package of HIV prevention services for KP/PP
- Short-Term Outcomes:
  - Increased awareness, acceptability, and demand for prevention services among KP/PP
- Intermediate Outcomes:
  - Increased uptake of prevention services among KP/PP
  - Reduced HIV high-risk sexual behaviors among KP/PP
Strategy 3: Provide high quality VMMC services to KP/PP
- Short-Term Outcomes:
  - Increased awareness, acceptability, and demand for VMMC services for KP/PP
  - Reduced VMMC adverse events
- Intermediate Outcomes:
  - Increased uptake of VMMC among KP/PP
Strategy 4: Establish a strong surveillance program to monitor and inform the implementation KP/PP HIV prevention services
- Short-Term Outcomes:
  - Improved data collection and quality
- Intermediate Outcomes:
  - Improved data use to inform program decision making

Strategies and Activities

Strategy 1: Develop, implement, and coordinate effective case findings, high-yield testing modalities, and linkage strategies for KP/PP, including but not limited to:
- Conduct demand creation activities targeting KP/PP at highest risk
- Provide HTS according to national guidelines and linkage to treatment
  - Use a combination of existing and innovative testing approaches to offer targeted testing to KP/PP and their sexual partners and children to increase testing yield
  - Implement established and new strategies to improve linkage to treatment
- Implement rapid test continuous quality improvement (RTCQI) components including internal/external quality assurance initiatives to improve tester performance and proficiency and overall rapid test quality (adherence to national RTQI guidelines)
Strategy 2: Develop and implement a comprehensive package of HIV prevention services for KP/PP, including but not limited to:
- Conduct demand creation and distribution of condoms and lubricant
- Provide pre-exposure prophylaxis (PrEP) services to high risk individuals among KP
- Provide trainings to reinforce prevention messaging, including trainings to:
  - Service providers on non-discriminatory service provision and GBV
  - Service providers on appropriate HIV services for KP/PP
- Work with HIV positive KP and support groups to improve retention and adherence to treatment
Strategy 3: Provide high quality VMMC services to KP/PP, including but not limited to:
- Conduct VMMC demand creation activities through various platforms
- Provide VMMC services according to national guidelines
- Ensure implementation of continuous quality improvement (CQI) activities at supported VMMC and referral sites
Strategy 4: Establish a strong surveillance program to monitor and inform the implementation KP/PP HIV prevention services which includes:
- Conduct regular data collection, analysis, and use to inform the program on a regular basisImprove data collection methods, monitoring, etc.
- Conduct population size estimates and BBSS

Funding Information

The Award Ceiling of this NOFO is $2,514,175.

Eligibility Criteria

The following entities are eligible to apply for this NOFO:

Government Organizations:
- Political subdivisions of States (in consultation with States)
Non-government Organizations:
- Alaska Native health corporations
- Tribal epidemiology centers
- Urban Indian health organizations
- Nonprofit with 501C3 IRS status (other than institution of higher education)
- Nonprofit without 501C3 IRS status (other than institution of higher education)
- Research institutions (that will perform activities deemed as non-research)
Colleges and Universities
Community-based organizations
Faith-based organizations
For-profit organizations (other than small business)
Hospitals
Small, minority, and women-owned businesses
All Other