EQUIP consortium member Anova Health Institute, has begun work on a technical assistance project with EQUIP Lesotho to support the Elizabeth Glaser Paediatric AIDS Foundation (EGPAF) in developing male-friendly services that will encourage men, including men who have sex with men (MSM), to engage with health care in Lesotho.

The USAID-funded Providing Universal Services for HIV/AIDS (PUSH) Project, aims to rapidly expand service coverage to 80 percent of people living with HIV in three scale-up districts by 2018, while sustaining services across six districts in the country.

“We were looking for technical assistance to pinpoint what defines male-friendly services, how to attract men to come back to these services after HIV testing, and what other services we should provide in addition to HIV testing to attract men,” said Esther Tumbare, EGPAF’s Director of Technical services in Lesotho.

As part of its PUSH project EGPAF is also seeking to develop services for key populations such as MSM. Improving HIV diagnosis and retention in care for all men will be critical in expanding service coverage. “We had questions about how to approach different populations of men when designing services,” said Esther Tumbare. “What would be the difference between a centre that is primarily focused on MSM compared to a centre that has open services for all men? Do you give the same services to the younger population of men as you do to the older population?”

Anova will use their experience of managing clinics in South Africa that are specifically designed for men, including MSM to support EGPAF in the development of clinic services targeted at men.

Ben Brown, Senior Implementing Officer at Anova said: “Guys generally don’t like testing for HIV, but do want to know that they can perform well sexually, so our practice has been to present men’s clinics as a sexual health and well-being service. This way, men can go to a clinic to discuss a range of issues, such as their concerns about erectile dysfunction or potential sexually transmitted infections (STIs), but then while there they can also be exposed to HIV testing and treatment services, or even pre-exposure prophylaxis (PrEP).” Linked to this approach, Anova will provide key population competency training to targeted health care workers as well as EQUIP Right to Care Lesotho and the Lesotho Ministry of Health. “Our clinic training model is very well-tested and has been used to improve health worker competency in many countries across Africa. This training addresses the health needs of all key populations, including both psychosocial and biomedical elements,” continued Ben.

“We wanted to learn from Anova’s experience in providing PrEP, and to learn about best practice in testing and monitoring protocols plus project monitoring and evaluation,” said Esther.

Anova will draw on their expertise in delivering PrEP to around 300 men at clinics in South Africa to develop PrEP demonstration projects including Namibia, where Anova is working in partnership with the Society for Family Health.

“We need to define the staff complement, training requirements for staff and the service delivery model we will use to introduce PrEP,” said Dr. Iyiola Faturiyele, the Country Director of EQUIP Right to Care Lesotho.

Another element of the technical assistance will focus on identifying suitable sites that will maximise the participation of men in health care services.