The Missing Link to HIV Care in Panama

by Alejandra Cabrera, Regional Strategic Communications, PASMO

Franklin Ocana’s fingers moved over his keyboard with swiftness and agility. “You showed them the coupon, right?” he wrote to one of his clients using WhatsApp. The 31-year-old client wrote back immediately: “Yes. Of course!”.

Franklin, a Panamanian cyber-educator working with the Pan American Social Marketing Organization (PASMO), PSI’s network member, under USAID’s Combination Prevention Program for HIV in Central America was checking in on several people he had referred to HIV testing and counseling (HTC) services. All of these people had been given coupons or vouchers to use at a network of private labs, called De Sedas, which are used to track service delivery and follow-up.

“What did you think of the service?”, Franklin asked. Three short responses appeared on his screen. “Excellent. Very nice. And fast!”

In May 2018, the Combination Prevention Program in Panama began a formal partnership with the De Sedas network to increase access to quality HTC services for at-risk men who have sex with men (MSM) and transgender women, who receive the services free of charge when they show the online voucher. De Sedas has six locations throughout Panama City, as well as a lab in the city of Chiriquí, and it proved to be an ideal partner upon completing a sensitization training on how to serve at-risk populations. The network of clinics quickly became a provider of choice for those who wanted quick and discreet services with access to a broad range of locations and opening hours to accommodate their work schedules.

Franklin has a broad and warm smile. “Our relationship with De Sedas is great”, he says. “When we send them someone and their test is reactive, we get a WhatsApp message informing us so someone from our team can give that person their test results with a formal post-test counseling process”.

The De Sedas lab is also authorized by the Ministry of Health to provide confirmatory testing services, so reactive users have the option to take a second sample to confirm their HIV status. This option reduces the time it takes to link new cases of HIV to specialized care after the rapid test. Once their diagnosis is confirmed, users can find care and treatment in the public health system and at comprehensive care clinics.

Cyber-educators like Franklin play a role in contributing to the global 90-90-90 goals—that 90 percent of HIV positive individuals know their status, 90 percent of those who know their status are on antiretroviral therapy medication and 90 percent reach viral load suppression—by identifying at-risk users, motivating them to know their HIV status and providing follow-up to ensure their entry into the HIV continuum of care if HIV positive. By the end of the 2018 fiscal year, nearly 40 private laboratories in Guatemala, El Salvador, Honduras, Nicaragua and Panama were providing HTC services under the Combination Prevention Program. Of the total number of reactive cases identified that year, 38 percent had been identified in private laboratories and sent to local Ministries of Health for tracking and data collection.

The effort to create and expand upon the network of private labs working under the Combination Prevention Program is a region-wide initiative. In countries such as El Salvador, the Program worked closely with the Salvadoran National AIDS Program to help standardize the manner in which private laboratories take HIV tests and report them to local monitoring systems. The Program trained the National AIDS Program staff in pre- and post-test counseling processes and sensitized them on issues around key populations and non-discrimination.

Franklin swivels his chair back to face the computer screen, making one request before his user signs off. “You can share my number with any friends you think might need this service.”

The user replied, “For sure. Going to do that now. And thanks!”

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