Papua New Guinea is facing twin epidemics of HIV and gender-based violence (GBV), and GBV is one of the most significant barriers to reaching the 90-90-90 global target for HIV and AIDS programming.
An estimated two-thirds of women in the country experience GBV during their lifetime. Recognizing this widespread occurrence and the direct link to HIV, FHI 360 began to integrate post-GBV care into existing health services through the Strengthening HIV/AIDS Services for Key Population in Papua New Guinea project, which is funded by the U.S. Agency for International Development. FHI 360 trained health care workers to routinely screen all clients for GBV, manage GBV cases and provide post-GBV services in nine clinics that provide HIV, sexually transmitted infection (STI) and outpatient services in Madang and Port Moresby. Previously, each of these areas had only one family support center offering limited post-GBV services.
Survivors identified through screening, as well as those who walked in voluntarily or by referral, were offered post-GBV care. This package of care included psychological first aid, provider-initiated counseling and testing, post-exposure prophylaxis, emergency contraception, STI prophylaxis and vaccination against tetanus and hepatitis B.
In partnership with ChildFund and the Family and Sexual Violence Action Committee in Papua New Guinea, FHI 360 also supported a national hotline for GBV survivors. The hotline, still ongoing, primarily provides callers with information on where to access services. Telephone counseling, information on rights and service referrals are also available. More than 4,900 individuals used the hotline since its inception in August 2016. Among them, more than 3,000 were referred for related post-GBV services, including law enforcement and the justice system, welfare and shelter services, counseling, and clinical and HIV-related care.
Additionally, FHI 360 strengthened the capacity of local implementing agencies and national programs to provide GBV services through:
- Formal training using participatory adult education methodologies
- Training of trainer workshops
- Educational visits between hotline staff and clinical staff
- Ongoing mentorship and supervision
- Assistance in developing information, education and communication tools; standard operating procedures; and data collection tools and guidelines
FHI 360 also supported national GBV care programs by facilitating the development of numerous tools and guidelines, including the first national clinical guidelines for GBV case management, the national GBV referral pathways and implementation of safe house services.
Post-GBV care was first integrated into HIV/STI clinics in 2015. From that time to 2018, the number of clients accessing those services who were also screened for GBV increased by 57 percent. This increase was more dramatic among key populations (female sex workers, men who have sex with men and transgender people), which increased 72 percent between 2016 to 2018.
By increasing the number of service points and providing integrated, comprehensive GBV services combined with community awareness, FHI 360 had a significant impact on the uptake of post-GBV care in Papua New Guinea. And, by leveraging existing services and staff, the project delivered cost-efficiencies and time-sensitive services.
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