Tools and Guidelines

This training aims to impart practical knowledge and skills to health workers across Asia. Evidence indicates that substantially different HIV prevention challenges are posed by men who have sex only with other men, compared to men who have sex with men and women. These two groups are unlikely to respond to the same prevention messages and advice. This training module focuses specifically on reaching out to the female partners of MSM. As such, the module builds on the existing training package for health care providers developed by UNDP and the World Health Organization (WHO) in 2013. The UNDP/WHO regional training package, entitled “The Time Has Come”, aims to reduce stigma in health care settings and to enhance HIV, sexually transmitted infections (STI) and other sexual health services for MSM and transgender people in Asia and the Pacific.

Sexually transmitted infections (STIs) are a major public health problem worldwide, affecting quality of life and causing serious morbidity and mortality. STIs have a direct impact on reproductive and child health through infertility, cancers and pregnancy complications, and they have an indirect impact through their role in facilitating sexual transmission of human immunodeficiency virus (HIV) and thus they also have an impact on national and individual economies. More than a million STIs are acquired every day. Since the publication of the World Health Organization (WHO) Guidelines for the management of sexually transmitted infections in 2003, changes in the epidemiology of STIs and advancements in prevention, diagnosis and treatment necessitate changes in STI management. These guidelines provide updated treatment recommendations for genital Herpes simplex virus (HSV) infection based on the most recent evidence; they form one of several modules of guidelines for specific STIs.

This document guides countries through the process of collecting and reporting sub-national data on adolescents to inform programme planning and implementation efforts. This guidance has been developed with the specific aim of identifying data gaps for adolescents and informing immediate programme planning needs at the sub-national level. Specifically, where national systems are being adapted to integrate adolescent sex- and age-disaggregated data into routine monitoring, this guidance informs interim measures to fill data gaps to capture and report adolescent ageand sex-disaggregated data. It is neither designed nor intended to replace existing national monitoring or global reporting mechanisms. As the content of this guidance draws on examples primarily from the HIV sector to illustrate the collection of sub-national data and service site statistics, it has drawn heavily on the WHO Consolidated Strategic Information Guidelines for HIV in the Health Sector.

Although much knowledge has been transferred from the global South to the global South (S2S) and numerous guides have been produced about mentoring, few tools exist to guide mentors in how to best conduct S2S mentoring. In S2S mentoring, all organizations involved, including the mentors and mentees, are rooted in the global South and have direct experience operating in complex environments in low- and middle-income countries. Mentoring can be provided more regularly and more efficiently by organizations in the same or neighboring countries and is often more readily accepted when the mentor’s messages, approaches, experiences, and lessons learned come from a setting similar to that of the mentee's. LINKAGES designed this toolkit to support and guide existing mentors from key-population-led organizations (KPOs) in the global South to enhance the quality of mentoring support available to other KPOs in the global South. Specifically, this toolkit aims to support mentors in the global South to understand what S2S mentoring is, their role in S2S mentoring, different S2S mentoring approaches and how to choose among them, and the technical skills needed to mentor effectively.

This publication provides guidance to governments, civil-society organizations (nongovernmental organizations [NGOs] and community-based organizations), and other partners implementing HIV prevention, care, and treatment programs with key populations. The approach recognizes that site-level monitoring and individual tracking are needed to ensure that key population individuals access high-quality outreach and clinical services routinely, and that these services are run efficiently. This guide is designed to assist these programs as they establish monitoring systems that are used by frontline workers, including peer outreach workers, staff outreach supervisors, program managers, and others to understand performance. It includes comprehensive tools and forms that various levels of staff can use to collect and analyze data to manage and improve the program. These include population size estimation tools, mapping tools, facility monitoring tools, and client registers.

The HIV and social protection assessment tool is used for a quick scan of existing social protection programmes and their sensitivity (or lack of) to the HIV response in a given country and location. Additional follow-up and research that engages the different critical actors, including HIV programme managers, social protection administrators, beneficiaries and civil society representatives, may be necessary in some contexts. The assessment provides countries and communities with tailored analysis on HIV and social protection. Information gathered using the assessment tool is intended to support decision-making in strengthening the HIV sensitivity of social protection schemes to better reach people living with HIV, adolescent girls and young women, key populations and others, and inform the development of national HIV-sensitive social protection portals, revision of national AIDS strategies, HIV investment cases, concept notes for the Global Fund to Fight AIDS, Tuberculosis and Malaria, and other social welfare and poverty alleviation programmes.

Sri Lanka remains as a very low prevalent country for HIV since the first Sri Lankan was diagnosed with HIV in 1987. Current estimate (2015) for people living with HIV (PLHIV) is 4200 including estimated 100 children. By end 2015, a cumulative total of 2309 HIV positive persons were reported to National STD/AIDS Control Programme (NSACP) with a continued upward trend over years. Antiretroviral therapy (ART) for prevention of mother to child transmission (PMTCT) was introduced and available free of charge for pregnant mothers diagnosed with HIV in Sri Lanka in 2002. All diagnosed PLHIV were linked to care at NSACP HIV clinics and ART was available and provided free of charge from 2004. At present, HIV care services are available in all provinces of Sri Lanka under direct supervision of consultant venereologists. Eligibility criteria for ART were changed over years and at present the country adhere to “Test and Treat” policy where everyone diagnosed with HIV are eligible for treatment irrespective of CD4 count, viral load or HIV clinical stage.

Antiretroviral Therapy (ART) should be initiated in all pregnant and breastfeeding women living with HIV regardless of WHO clinical stage and at any CD4 cell count and should be continued lifelong. ART should be initiated as early as 14 weeks of gestation or as soon as possible thereafter during pregnancy. However, even if they are identified late in pregnancy or postpartum, ART should be initiated immediately as it is the most effective way to prevent mother-to-child HIV transmission. All efforts should be made to identify HIV-infected pregnant women early enough to avoid the need for high-risk prophylaxis for infants. The guidlines for management of pregnant women with HIV infection - 2016 was prepared to assist policymakers to plan prevention of mother-to-child transmission (PMTCT) interventions and healthcare workers to provide optimal services to pregnant mothers.

Syphilis is a sexually transmitted disease which may cause genital ulcer disease in the primary or secondary stages. However, majority of persons infected with syphilis remain asymptomatic making it difficult to identify the infection. These asymptomatic patients can be identified only through serological screening. If a woman has symptomatic or asymptomatic syphilis, infection can be transmitted vertically from mother to child resulting in congenital syphilis in the baby. Syphilis is a condition which can be cured with penicillin treatment. Treatment of pregnant women having syphilis with penicillin treatment prevents congenital infection. Early identification and treatment of syphilis among females will reduce the risk of both sexual transmission and mother to child transmission.

Early detection and appropriate interventions improves survival and quality of life of people infected with HIV and reduces the risk of onward transmission. However, a significant proportion of people living with HIV, remain undiagnosed until they become symptomatic, therefore presenting late for treatment. Late presentation diminishes the impact of ART on morbidity and survival and delays adoption of preventive measures by persons living with HIV and their partners. The national HIV testing guidelines is the principal document that sets out the objectives, principles and arrangements for HIV testing in Sri Lanka. These guidelines are based on the National AIDS Policy and National HIV Strategic Plan 2013-2017. They provide guidance on HIV testing in the country. This ensure quality screening and diagnostic testing become readily accessible, with the aim of identifying HIV infection early so that risk reduction and timely initiation of treatment of infected individuals will be facilitated. Aiming to address this, HIV testing is scaled up with protection from stigma and discrimination in variety of settings. In all settings under which people undergo HIV testing steps are taken to protect human rights and ethical principles.