Number of MARP reached with individual and/or small group level HIV preventive interventions that are based on evidence and/or meet the minimum standards required

Export Indicator

Number of MARP reached with individual and/or small group level HIV preventive interventions that are based on evidence and/or meet the minimum standards required
What it measures

It is important to know how many people complete an intervention in order to monitor how well programs are reaching the intended target population with HIV prevention programming.

Headquarter staff can use this information to plan and make decisions on how well a certain target population is being reached with individual and/or small group level interventions. If a small percentage of the intended target population is being reached with either one intervention, then it would be recommended that activities are adjusted to improve reach. If a large percentage of the intended target population is being reached, then headquarter staff would want to take these lessons learned and disseminate them to other countries. The country can use the information to improve upon the quality of the program as well as scale-up successful models.

Rationale

Individual and small-group level prevention interventions have been shown to be effective in reducing HIV transmission risk behaviors. Delivering these interventions with fidelity to the appropriate populations is an important component of combination HIV prevention strategies.

Numerator

Number of MARP reached with individual and/or small group level preventive interventions that are based on evidence and/or meet the minimum standards required

Denominator

Total estimated number of MARP in the catchment area*
*Recommended at partner level only

Calculation
Method of measurement

Explanation of Numerator:

The numerator can be generated by counting the number of de-duplicated individuals from an activity defined target population who are reached with prevention intervention designed for the intended MARP.

This indicator only counts those interventions at the individual and/or small group level. Individual and small group level interventions are components of a comprehensive program but are not by themselves defined as a comprehensive program. Partners do not have to implement comprehensive prevention programs to utilize this indicator, but should work with other partners and stakeholders to ensure that comprehensive prevention programs are implemented in the communities that they work in.

Additional possible disaggregation - Country defined vulnerable or high risk populations

Please note, within each country, there may be other populations that have increased vulnerability to HIV due to a combination of behavioral, social, or environmental factors. These factors include frequent separation from a main partner or family support structure due to mobility or migration, economic disparities related to gender or ethnic group, patterns of alcohol use that facilitate HIV risk behaviors, and incarceration. Other populations that can be considered to be at higher risk than the general population include:

o Military and other uniformed services
o Men and women engaging in transactional sex
o Incarcerated persons
o Mobile populations (e.g. migrant workers, truck drivers)
o Street and other vulnerable youth
o Persons who engage in alcohol-associated HIV sexual risk behaviors

PEPFAR Teams may wish to implement other population disaggregation from these 6 categories above for their own in-country program management. Any additional other disaggregation other than the essential/reported MARP categories (IDU, MSM, and CSW) will not be collected at the OGAC level and should not be included in the aggregated count of individuals submitted for this indicator for reporting purposes.

Core Package of Services for MARPS: Based on the epidemiologic profile for each country the aim of the country team should be to scale-up a combination of targeted interventions adapted for different sub-groups especially vulnerable to HIV. These interventions could include but are not limited to:
• Community-based peer outreach
• Voluntary testing and counseling (If providing these services, also use indicator #P11.1.D)
• Behavior change programs including targeted condom distribution for those who practice high-risk sexual behavior
• Diagnosis and treatment of STIs (If providing these services, also use indicator #C2.1.D)
• Referrals to a range of substance abuse and treatment services
• Linkages through referral networks with other health services
• Programs to prevent alcohol/drug- related sexual risk-taking behaviors and HIV transmission
• Vocational skills training or other income-generation activities
• Drop-in centers for creation of “safe space”
Service models (e.g. VCT) developed for a general population may need to be adapted to reach, engage and meet the needs of most-at-risk populations. The country team is encouraged to incorporate tailored or innovative approaches that are likely to increase access and remove barriers to services for these populations. Use of qualitative methods to guide these adaptations has proven to be an effective strategy. 

The network model encourages and supports linkages to care and treatment as well. Keeping linkages in mind as care and treatment programs are planned will help achieve the overall PEPFAR goals and assist MARP populations.

Commercial Sex Workers (CSW): Effective CSW prevention

Measurement frequency

Continuously

Disaggregation

Gender: Male, Female

Target: Clients of sex workers, Injecting drug users, Men who have sex with men

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

This indicator provides information on the total number of unduplicated individuals that received individual-level and/or small-group level interventions. These interventions are based on evidence and/or meet the required minimum standards. The indicator will help the country teams to determine reach (if no denominator) and coverage (if denominator is also collected) to help country programs understand the extent and reach of evidence-based programs for further expansion.

Further information