In El Salvador, PSI’s network member is the Pan American Social Marketing Organization (PASMO). Founded in 1998, PASMO El Salvador began activities as part of a regional HIV prevention program. Subsequently, their scope expanded to other health areas such as reproductive health, including post-abortion care, gender-based violence prevention, nutrition, and Zika prevention.
In El Salvador, two registered entities work side-by-side to improve the health of Salvadorians – one is a social enterprise company and the other is a not-for-profit organization. The prior focuses on post abortion care, harm reduction and safe abortion within the context of the law. while the latter focuses on implementing U.S. Government funded HIV and Zika programs, as well as the Maverick Collective reproductive health program.
PASMO estimates that in 2016, its products and services helped avert 15,000 DALYs in El Salvador, including, by health area:
- 11,500 HIV DALYs
- 4,000 FP DALYs
- 1 Safe Abortion DALY
PASMO’s family planning programs also provided 73,461 couple-years of protection.
HIV prevention activities in El Salvador are carried out under a combination prevention approach. Key populations such as men who have sex with men (MSM), transgender women, and female sex workers are targeted with outreach interventions focused on knowing one’s HIV status, in combination with the promotion of HIV testing and counseling (HTC) services, and referrals to structural or complementary services. PASMO also works to ensure that individuals with reactive test results are linked to care, and also provides adequate support to HIV positive persons along the HIV continuum of care.
HIV prevention efforts also include initiatives such as the Generación Cero social movement, designed to reduce stigma and discrimination towards key populations and persons living with HIV.
PASMO El Salvador, through the aid of the Maverick Collective Initiative, has also placed a special emphasis on strengthening youth-friendly services. This is evidenced through the establishment of its first social franchise clinic, the Red Segura Clinic, which offers integrated, comprehensive, primary care services with a focus on adolescent sexual and reproductive health. The objective is to prevent teenage pregnancy and promote positive parenting in youth ages 15 to 24. The Maverick Collective Initiative also includes a social component, which involves facilitating healthy behavior change among youth through girls clubs, parenting support groups, and workshops for young fathers to promote male involvement in parenting , while reducing harmful gender norms.
PASMO El Salvador markets and sells condoms and lubricants, in addition to other socially marketed family planning products. Their programs are aimed to help reduce HIV transmission and improve sexual health, a strategy that complements social and behavior change communication activities. PASMO El Salvador also recognizes the importance of directing efforts to improve the availability and accessibility of condoms for the population, especially for those with a greater risk of HIV infection.
To achieve integrated, efficient and sustainable HIV prevention, condom use is crucial; therefore, the condom availability and accessibility program focuses on product distribution by means of three distribution channels:
- Traditional, which is specifically made up of pharmacies.
- Non-traditional, which consists of sales points where condom sales do not traditionally take place e.g. convenience stores, supermarkets, “mom-and-pop” stores, warehouses among others.
- High-risk channels, which comprise sales points such as night clubs, motels, date houses, etc. that are linked to or highly associated with commercial sex work.
PASMO El Salvador recently introduced a project to address Zika in the country. Working closely with the Ministry of Health and other partners, the project works to improve community engagement and quality of services involved in Zika prevention. Activities include outreach through community events, private health clinics and a mass media campaign using radio, billboards, and other forms of media targeting women of reproductive age. The objective of the program was to educate women about the misconceptions, signs, symptoms and prevention of Zika. Another key element of the project is the distribution of Zika prevention kits, which include informational materials, condoms and insect repellant.
Post Abortion Care and Harm Reduction
The Women’s Health Project (WHP) started in July 2008, now operates as a social enterprise company separate from the PASMO El Salvador not-for-profit organization. One of its goals is to increase access to long acting reversible contraceptives (LARCs) for women of reproductive age. Doctors, nurses, coordinators, and community outreach workers collaborate with the program to offer a diverse range of family planning methods, including intrauterine devices (IUDs) and implants. This formal network of partners named the Alianza de Profesionales para Salud. Marketing strategies and social behavior change communication (SBCC) are also used to promote and create demand for family planning products and services among patients and providers.
The project also promotes and facilitates the use of misoprostol and manual vacuum aspiration (MVA) for post abortion care (PAC) through provider trainings and support, health care ethics workshops. It also encourages provider behavior change communication activities and offers support for PAC inclusive of family planning. The project registers and markets MVA packs and misoprostol and is working alongside advocacy groups to shift abortion policy in the country to allow abortion in certain circumstances, such as endangerment to the life of the mother, or rape. In addition, the initiative works to sensitize the Ministry of Health and Social Security on PAC and unsafe abortion issues to decrease the stigma around seeking PAC and influencing a broader harm reduction strategy.
- Ministry of Health
- Ministry of Education
- Social Inclusion Secretariat
- Local NGOs
- Crisis in the Triangle: Addressing Adolescent Reproductive Health & Violence Prevention in El Salvador, Guatemala and Honduras
With the largest youth population in history, it is critical to bring together and evaluate the most promising practices from health, violence prevention, protection and education, to develop – in partnership with young people–programs, evidence based research and opportunities that will transform the Northern Triangle countries into safe and healthy places for young people to thrive.
- “Mamá Segura” Delivery Kits Summary
Socios públicos y privados reciben donación de kits “Mamá Segura” para prevenir la transmisión del virus del Zika en mujeres embarazadas Centroamericanas.
Public and private partners have donated "Mamá Segura" kits to prevent transmission of the Zika virus in pregnant women in Central America.
- Improving Provider Behavior Change Communication and IPC: Best Practices from the Women’s Health Project
This brief describes the challenges faced, strategies developed, and lessons learned by the Women's Health Project. It also proposes a set of best practices for improving productivity of interpersonal communications (IPC) agents and increasing providers' skills and motivation.
- “The ART of Synergy”: Qualitative Study on Barriers to HIV Treatment Adherence among PLWH in Central America
This presentation includes the results from a qualitative study on barriers to HIV treatment adherence among men who have sex with men.
- Barriers and Motivators to Treatment Adherence Among Transgender Women in Central America
PASMO conducted a qualitative study to explore the barriers to antiretroviral therapy adherence faced by HIV-positive transgender women in Nicaragua, El Salvador, and Costa Rica.
- “Sometimes We Take a Vacation”: Qualitative Study on Barriers to HIV Treatment Adherence Among PLWH in Central America
In 2012, PASMO conducted formative research to explore barriers and strategies people living with HIV (PLWH) use to achieve antiretroviral therapy (ART) adherence.
- The Effectiveness of the USAID Combination Prevention Program for Preventing the Spread of HIV Among Key Populations in Central America
PSI/PASMO recently published four peer-reviewed articles on the effectiveness and innovation of the USAID Combination Prevention Program for HIV in Central America.
- Cyber-Educators In Latin America
In Latin America, PASMO has employed cyber-educators to reach young MSM with HIV prevention information through online chat rooms. Check out this video explaining their approach.
- Integrating HIV prevention and family planning for a better future
Launched in 2010 by PSI's Central American affiliate, PASMO, the Combination Prevention Program for HIV offers an integrated approach to prevention that combines testing and counseling, condom promotion and distribution, and family planning, as well as other services to promote an improved well-being.
- Effectiveness of Behavior Change Communications for Reducing Transmission Risks Among People Living with HIV in 6 Countries in Central America
This first region-wide study aims to estimate prevalence of HIV-related risks (sexual behavior, HIV disclosure, number of sex partners, violence) and factors associated with these risks as well as evaluate a behavior change communications program targeted to PLHIV in 6 countries in Central America. After 2 years, the program achieved moderate coverage, with 21% of the sample reporting exposure to interpersonal communications (IPC) and 52% to mass media program components.