PSP-One Guatemala was launched in January 2007 and will continue until 2009, concentrating on three Departments in the country: Guatemala City, Quetzaltenango and Izabal. The project is working mainly with private physicians and private lab owners (or biochemists) to achieve its goal through a diverse array of strategies that fall under three components:

1. Policy Improvement

2. Private Sector Quality Improvement

3. Research and Development of CT Models

National Commission on HIV/AIDS
PSP-One has created a National Commission on HIV/AIDS, which serves as a dialogue mechanism for all sectors on the topic of HIV/AIDS. Members of the Commission include:

• National AIDS Program (Programa Nacional de SIDA – PNS)
• Several medical associations such as National Association of General Practitioners, Internists, and Women Physicians
• Association of Biochemists
• Certifying body for labs
• HIV-related NGOs

The Commission is a working body of dedicated volunteers representing their organizations that meet on a regular basis to improve coordination and standardization of HIV services among all sectors in Guatemala. Topics to be discussed and tackled by the Commission include:

• How to consolidate and disseminate information on national HIV CT protocols and guidelines to private health providers efficiently
• How to institutionalize training of private providers on HIV/AIDS among the professional associations
• What are the gaps in the process for HIV CT in Guatemala and how can the private sector be strengthened to fill those gaps
• How should the PNS reconcile the regulation of rapid, self-administered HIV tests with the need for proper counseling

Strategic Linkages with Professional Associations

In addition to the Associations’ participation in the National Commission, PSP-One has formed close ties with these organizations that have allowed access to thousands of private health professionals. PSP-One is regularly invited to attend Association meetings, where the project has a chance to increase private providers’ awareness about HIV.

In December 2007 PSP-One had a prominent participation in the Annual Congress of the National Medical Association, which was a high-profile event commemorating the Association’s 50th anniversary. During this event, PSP-One, the Medical Association, and the PNS signed a declaration calling to action all private doctors in the country to join the fight against HIV/AIDS.

Click here to read about our HIV/AIDS Declaration

PSP-One was also present at the Central American regional HIV conference CONCASIDA (www.concasida2007.org) in November 2007. The project sponsored the attendance of key private providers and organized the satellite symposium “HIV Counseling and Testing: Beyond the Public Sector”, which reviewed different experiences with CT in the private and NGO sectors in different countries in Central America and promoted lively discussions on the potential of these sectors to provide quality CT.

Private physicians and private lab owners have rarely been included in public sector and NGO trainings in Guatemala. PSP-One is training these providers on HIV CT, working closely with professional associations to reach a maximum number of providers and to institutionalize the trainings to ensure their sustainability beyond the life of the project. All of PSP-One’s trainings provide participants with Continuing Medical Education (CME) credits for their participation. Click here to read more about PSP-One training

PSP-One is establishing partnerships with pharmaceutical companies involved in HIV/AIDS to leverage resources in the efforts to improve CT services in the private sector. For example, the project will enter into agreements with manufacturers of HIV drugs and/or test kits to use their detailing and distribution infrastructure to reach private providers with information on HIV and CT.

Research

Although many studies have been conducted on HIV services, including in Guatemala, those rarely focus on the private health sector. PSP-One Guatemala research is producing valuable information on the CT services provided by the private health sector, which guide project activities and add to the currently weak body of knowledge on the topic.

At the beginning of the project, PSP-One conducted a rapid assessment of the HIV CT services offered by private physicians and laboratories. This was the first time anyone assessed these services in the private sector in Guatemala, and the assessment findings have been key to informing PSP-One project activities. Some of the main findings from the assessment are:

• Only 38% of doctors provide pre-test counseling to patients
• Although all doctors provide post-test counseling to patients who test positive, only 19% do so for patients who test negative
• Only 5% of doctors know about the PNS counseling norms, but this percentage is much higher for biochemists, 38%
• All private providers are interested in being trained on HIV topics

PSP-One is conducting a qualitative study to assess the stigma and discrimination faced by MARPs seeking HIV CT services in the private sector. A similar study has been conducted in the public sector in Guatemala and the results from the PSP-One study will allow for a comparison of stigma and discrimination between the public and private health sectors. Results of the study will also be used in the development of the training curriculum for private providers.

Development of New CT Models

Given the focus that is usually given to the public and NGO sectors in the formulation of policies and recommendations, PSP-One acknowledges that current HIV CT practices and guidelines may not be the most conducive to the unique private sector setting. The project will explore and develop new cost-effective pre- and post-test counseling modalities that can be piloted with private providers to increase their provision of quality CT to MARPs.

PSP-One Country Programs: