Costa Rica is the most visited nation in Central America with about 2 million visitors annually. With only 4.4 million of its own people and many undocumented immigrants, its transient culture makes accurate disease surveillance difficult. However, HIV is considered a steady-state epidemic. Annual HIV incidence has held steady over the last few years – especially among men who have sex with men (MSM).
PSI opened a Costa Rica office in 2002 to improve HIV/AIDS prevention strategies through social marketing. Since then, PSI/Costa Rica has worked to help prevent HIV/AIDS and other sexually transmitted infections by selling high-quality male in local markets at competitive prices. PSI/Costa Rica also works with the Ministry of Health and various NGOs to help train, educate and empower high-risk populations.
Costa Rica is also a part of the Pan American Social Marketing Organization (PASMO), along with Belize, El Salvador, Guatemala, Honduras, Nicaragua and Panama. PASMO’s productive relationships with more than 50 nongovernmental and faith-based organizations, Ministries of Health, National AIDS Programs, wholesale and retail distributors, advertising agencies, research organizations, donor agencies and international organizations promote HIV/AIDS prevention and positive reproductive health programs.
PASMO estimates that in 2015, its products and services helped avert 965 DALYs in Costa Rica, including, by health area:
- 846 HIV DALYs
- 120 FP DALYs
PASMO’s family planning programs also provided 12,298 couple-years of protection.
Official estimates set HIV prevalence between 4.5 to 6.5 recorded cases per 100,000 Costa Ricans. However, the actual number of cases is most likely higher due to the transient culture and widespread stigma that prevents many from using HIV/AIDS-related health services. Transmission throughout Central America is typically associated with heterosexual sex – except in Costa Rica, which has a higher share of infected MSMs. The “Tienes. Pidelo.” (Have it. Ask for it.) campaign targets high-risk groups in brothels, bars and night clubs. The campaign includes laying out educational material, demonstrating correct condom use and providing condoms to vulnerable populations.
Other PSI interventions target the more than half of Costa Ricans – 58 percent – who live in urban areas because they also have the highest rates of infection. The PSI/Costa Rica sales team uses nontraditional channels to promote the VIVE condoms as well as proper and constituent condom use in general.
- The Federal Republic of Germany through KfW Entwicklungsbank (the German development bank)
- The Global Fund To Fight AIDS, Tuberculosis and Malaria
- U.S. Agency for International Development
- The Bergstrom Foundation
- Royal Embassy of the Netherlands, Managua
- The Summit Foundation
- VIVE, Much More Than Just a Sustainable Condoms Socially-Marketed Brand (TUPEE601)
In response to the HIV epidemic in Central America, Population Services International (PSI) created in Central America, its affiliate, the Pan American Social Marketing Organization (PASMO) in 1996. PASMO's inception project was to launch a regional socially-marketed condom brand, “VIVE,” to improve availability of and access to high quality condoms. Sustainability of the brand and growth of the total market were core principles from the start of the project.
- “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.
- Use of a Unique Identifier Code System to Track Key Populations Reached Under a Combination Prevention Program in Six Countries of Central America
In 2010, the Pan American Social Marketing Organization (PASMO) began implementing a USAID-funded Central American Combination Prevention Program for HIV, targeting key populations at higher risk that are often hidden, marginalized, and mobile. This presentation discusses that program
- Can a Combination Prevention Strategy Reduce HIV Risks for MSM in Central America?
Men who have sex with men (MSM) are one of the most affected key populations in Central America, with HIV prevalence ranging from 7.5 to 11.1 percent. This presentation discusses an evaluation which aimed to assess population-level coverage of specific and combined intervention components among MSM and to determine whether program exposure to any or a combination of components was associated with HIV risk reduction behaviors in this populations.