Positive Action Foundation Philippines Inc. (PAFPI) awarded USAID subgrant for FY2025 HIV Programs – a major milestone!
Securing the USAID EpiC subgrant for FY2025 is a significant achievement and major milestone for PAFPI. It will enable the organization to expand its reach and enhance its services in HIV prevention, treatment, and community-based care programs explained below. With this support, PAFPI can strengthen its efforts to raise awareness, provide essential health services, and improve the quality of life for people living with HIV. This funding will greatly benefit those affected by HIV, and is a crucial step toward epidemic control, helping to reduce transmission rates and support affected communities in the Philippines and in the Southeast Asian Region.
The subgrant approval is based on PAFPI’s proposal for its innovative HIV program for FY2025, which adopts a more holistic approach. This aligns with the program title: “Holistic Psychosocial Interventions for Continuity of Treatment for PLHIV in NCR.” The period of the program is from October 1, 2024, to September 30, 2025.
In FY25, PAFPI will operate in Manila, specifically at its PAFPI Community Center (PCC) and the government-run Manila Social Hygiene Clinic, focusing on Pillar 2. Leveraging insights gained from a full year of implementing the Enhanced Psychosocial Community Case Management (EPCM) model, PAFPI will refine and finalize its practices, tools, and processes in Q1 FY 2025. This effort will emphasize the essential role of psychosocial support interventions (PSI) and EPCM in maintaining treatment continuity, achieving undetectable viral loads, and enhancing the overall well-being and quality of life of people living with HIV (PLHIV). These holistic interventions will be showcased at the Manila sites for replication at other EpiC locations.
Beginning mid-FY25, PAFPI, in collaboration with EpiC, will provide technical assistance to four EpiC sites—Bacoor SHC, Caloocan SHC, TDFI, and LAKAN. This assistance will help align their current case management practices with PAFPI’s best practices in PSI and EPCM. Through this technical support, PAFPI aims to enable government sites to embody the principles of the Universal Health Care Act (Republic Act 11223) by implementing truly person-centered interventions.
The subgrant is solely based on PAFPI FY2025 HIV program specifics of which it is expected to be carried out in a holistic approach:
(1) Enhanced Psychosocial Community Case Management (EPCM), (2) Provide Psychosocial Support Activities (PSAs), (3) Psychosocial Support Sessions and (4) ITT, RTT, CTT Interventions (PAFPI Cares Community Center (PCC), Manila Social Hygiene Clinic (MSHC), QUICKRES, Virtual Case Management, Viral Suppression)
To give a glimpse of the program specifics, short discussion analysis is outlined below:
(1.) Enhanced Psychosocial Community Case Management (EPCM) is a vital approach employed by Positive Action Foundation Philippines Inc. (PAFPI) to deliver comprehensive and person-centered support to people living with HIV (PLHIV).
The EPCM approach enables PAFPI to provide holistic support that addresses the medical, emotional, social, and psychological needs of PLHIV. This comprehensive method ensures that clients receive tailored care that enhances their overall health and quality of life.
Each client is provided with a customized care plan that addresses their individual needs. In addition to focusing on physical health, EPCM also prioritizes mental well-being by offering counseling services and creating safe spaces for clients to express themselves. Support groups and activities are available to help clients cope with stigma, anxiety, and other psychological challenges. Furthermore, EPCM includes provisions for emergency situations, ensuring that clients can access immediate assistance during crises related to health, housing, or safety.
The Enhanced Psychosocial Community Case Management approach by PAFPI is designed to deliver comprehensive, continuous, and compassionate care, ensuring that people living with HIV (PLHIV) receive the support they need to lead healthy and productive lives.
Key components of the EPCM are as follows:
- The Psychosocial Officer (PSO) will automatically offer Enhanced Psychosocial Case Management (EPCM) as a standard of care to all clients who test reactive, although clients have the option to opt out. The PSO will also encourage all RTT clients to participate in EPCM, with those who agree being onboarded by the PSO. Additionally, the Local Government Unit (LGU) or Global Fund (GF) Peer Navigator (PN) can initiate the process:
1.1 The PSO discusses the consent form with the client and obtains their consent, which can be provided via a physical form or a Google form.
1.2 The PSO conducts a Quality-of-Life assessment using the 20-question QOL20 tool to establish a baseline for the client’s quality of life. This QOL20 is based on the WHO QOL tool, which has been streamlined in FY24 to make it more manageable for case management implementation, as the original WHO tool is often too lengthy.
1.3 The PSO assists clients in completing the SHARE self-assessment tool, which serves as the foundation for EPCM interventions. Unlike standard biomedical case management, color coding is not applied; instead, a “Yes” response on the SHARE tool indicates that the case manager should further explore whether an intervention is necessary. SHARE stands for:
– S: Safety, Security & Spirituality, Sexuality & Expression, Suicide, Mental Health, Depression
– H: Home, Health, Hobbies & Recreation
– A: Aspirations and Motivation, Alcohol/Smoking/Substance Use, Abuse and Violence
– R: Rest and Relaxation, Relationships with Family, Relationships with Peers
– E: Eating and Exercise, Employment and Education, Environment
The PSO completes the basic information on the intake form and gathers details about the client’s family, work, and age. The PSO then refers the client to a case manager. This entire process should take no longer than 30 minutes.
- The Case Manager (CM) then proceeds to the EPCM phase:
2.1 The CM validates the SHARE assessment in detail with the client, probing further and requesting additional information in areas where the client indicated a “Yes” response. The SHARE tool also helps CMs identify clients who require prioritization in the EPCM process.
2.2 (Relevant steps in the process follow)
(2.) Provide Psychosocial Support Activities (PSAs)
PSAs are grounded in social learning theory, which posits that individuals acquire new behaviors by observing and imitating others in a social context. In this program, people living with HIV (PLHIV) share their personal experiences—such as how they maintain their treatment, the support they receive from family and friends, and their individual best practices. To facilitate this process, PAFPI will engage PLHIV who have been on treatment for a while and have relevant experiences to serve as informal resource persons.
In response to identified needs, PAFPI will provide specific and appropriate PSAs for groups of PLHIV. Examples of PSAs include:
– **ARV Refill Day**: PAFPI will gather clients facing similar challenges related to their ARV refills (such as lack of multi-month dispensing or side effects) to offer mutual peer support. Participants will share their struggles with ongoing treatment and collaboratively develop ideas to support each other in adhering to their treatment plans.
– **Disclosure Day**: PAFPI will assist clients in disclosing their HIV status to partners, family members, and friends. Clients who have previously disclosed will be invited to share their experiences.
(Other Relevant Activities Follows)
In addition to these structured sessions, informal peer learning opportunities, such as “kamustahan sessions,” will promote social integration among clients, encouraging them to organically form support groups that can assist each other.
For all PSAs, diagnostic and prevention commodities will be provided in collaboration with the local government unit (LGU).
This initiative is new for FY25, and PAFPI aims to conduct 24 PSAs to reach 240 clients. PAFPI will collaborate with partners like the Department of Social Welfare and Development (DSWD) to cover meal and venue costs, thereby reaching a broader audience for these activities.
(3.) Psychosocial Support Sessions (Group Learning Sessions (GLS), Family Development Sessions (FDS), Support Group Sessions (SGS1, SGS2, SGS3))
(4.) ITT, RTT, CTT Interventions (PAFPI Cares Community Center (PCC), Manila Social Hygiene Clinic (MSHC), QUICKRES, Virtual Case Management, Viral Suppression)
Refer to definitions below:
- ITT: interrupted to treatment
- RTT: return to treatment
- CTT: continuity to treatment