Since 2001, PSI/Lesotho has been a leader in high-impact, national-level and community-based HIV testing services programs. PSI began its operations in the Kingdom of Lesotho by launching a condom social marketing program and a network of HIV testing services. These remain a model of efficiency and government partnership, especially with the Ministry of Health. With field expertise that spans community-support, service delivery and social behavior change communication, PSI/Lesotho is an expert at navigating the Lesotho health system, and pushing for the health results that the Basotho community need in order to thrive.
PSI/Lesotho estimates that in 2015, its products and services helped avert 931,259 DALYs, including, by health area:
- 870,890 HIV DALYs
- 60,369 FP DALYs
PSI/Lesotho’s family planning programs also provided 255,453 couple-years of protection.
These statistics include the impact of sales and distribution of condoms by PSI/South Africa, PSI’s regional commercial entity in Southern Africa.
HIV/AIDS
The U.S. President’s Emergency Plan For AIDS Relief (PEPFAR) prioritizes five districts which PSI currently works in: Maseru, Leribe, Mafeteng, Berea, and Mohale’s Hoek.
PSI/Lesotho provides community HIV testing services via stand-alone static sites, mobile sites, door-to-door home-based testing, and index client testing, and outreach activities. PSI is a key partner of the Ministry of Health and is Lesotho’s leading non-governmental provider of community-based HIV testing services (CBHTS). The Centers for Disease Prevention and Control funds the TARGET project, which is implemented by PSI/Lesotho. The New Start HIV testing services network is run under this, with static sites, and door-to-door and mobile outreaches throughout the five PEPFAR scale-up districts. In order to improve referrals and linkages, TARGET collaborated with the Elizabeth Glaser Pediatric AIDS Foundation to implement community antiretroviral therapy (ART) initiation. The initiative started in November 2016 to cover all five districts.
Through the TARGET project, PSI/Lesotho has directly contributed to Lesotho’s National Multi-Sectoral HIV Prevention Strategy. This has been achieved by reducing the impact of HIV/AIDS through the deployment of evidence-based strategies to provide confidential, community-based HTS services to men and women aged 15 to 35. Through TARGET, PSI/Lesotho has increased knowledge of individual and partner status. HIV testing and counseling (HTC) services has increased safer sexual behaviors. There is also increased use of post-test clinical care and social support services, through improved referral systems. Interpersonal communication activities (IPC) have promoted service uptake. They have also supported home-based testing, mobile outreach, standalone static sites, and index client testing.
Over the life of the TARGET project, PSI has tested more than 536,000 people for HIV. HTC services were targeted to locations and populations of greatest prevalence. In 2015 alone, PSI/Lesotho provided quality HTC services to 94,637 people with an average yield of 8% and referral rate of 64%. In addition to this core CBHTS programming, PSI/Lesotho also has an expansive portfolio including far-reaching HIV prevention behavior change communication campaigns, diagnosis and treatment of sexually transmitted infections, and comprehensive HIV prevention activities.
PSI/Lesotho is operating in partnership with the Lesotho Defence Force (LDF’s) to reduce the number of new HIV infections and other sexually transmitted diseases among active military personnel, their families, and the civilian communities they serve. This is being achieved through comprehensive voluntary medical male circumcision (VMMC) services (including HTC, service provision, and condom distribution), and intensifying community-based mobilization efforts in order to create informed demand for the service. From October 2012 to date, the program has circumcised 13,336 men with 13,309 (99.8%) knowing their HIV status. In mid-2016, PSI began to support strengthening of the LDF’s ART program through the training and provision of additional clinical staff to enhance and scale-up service delivery.
PSI/Lesotho is also leading the USAID-funded project, Lesotho Together Against HIV and AIDS Partnership (LETLAMA). This is a partnership of local and international NGOs designed to implement high-quality, locally-produced social and behavioral change communication (SBCC) interventions. The aim is to motivate individuals and create supportive communities for the adoption and sustained use of HIV prevention products and services. As of August 2016, the project had reached 33,266 individuals through community dialogues. In addition IPC successfully reached 46,518 men aged 20 to 49, and 27,014 adolescent girls and young women. The project also provided positive-living messages to 23,986 people living with HIV, as well as distributed 95,368,036 branded and generic condoms. In 2016, the LETLAMA project expanded its programming to include targeted IPC services for key populations, gender based violence prevention and school-based HIV prevention.
Through a USAID-funded sub-award agreement with the Vodafone Foundation, PSI/Lesotho is implementing the Mobilizing HIV Identification and Treatment (M-HIT) program. It aims to strengthen high yield HIV-positive identification and testing techniques for pediatrics, adolescents, and pregnant women; expand access and tracking to HIV-positive pediatrics; and improve pediatric HIV clinical services.
Donors
- U.S. Centers for Disease Control and Prevention (CDC)
- U.S. Agency for International Development (USAID)
- U.S. Department of Defense (DOD)
- Vodafone Foundation
Partners
- Lesotho Ministry of Health and Social Welfare
- Lesotho National AIDS Commission
- Lesotho Defence Forces
- Lesotho Inter-Religious AIDS Consortium (LIRAC)
- Lesotho Network of AIDS Service Organisations (LENASO)
- Phela Health & Development Communications (Phela)
- Apparel Lesotho Alliance to Fight AIDS (ALAFA)
- Kick 4 Life
- POC CD4 Testing Improves Effective Referrals From Community to Clinical Settings in Lesotho
The study conducted a retrospective analysis of 42,605 records of clients 2 years and older, seen between October 2014 and September 2015, through mobile HTC, home-based and static sites in Lesotho. A higher proportion of those receiving POC CD4 count were successfully linked to HIV care. Overall, these findings support deployment of more PIMA machines particularly at mobile and stand-alone HIV testing services where there are more HIV positives.
- Finding HIV-Positive Children and Adolescents, and Improving Effective Referrals
The study takes a targeted community-based approach of tracking index family members at risk of HIV in Lesotho. Results indicate that the index tracking model can be a viable method for reaching children who are HIV-positive. Referral uptake is high and will contribute towards high ART coverage among children and adolescents.
- AEA 2014: Serving the Poor and Sustaining Condom Markets – An Evaluation of Six African Countries
The Total Market Approach is a system in which all sectors – public, social marketing, and commercial – work together to deliver health choices for all population segments. The goal is to ensure that the poorest communities receive free products, those with slightly greater resources benefit from partially subsidized products, and those with a greater ability to pay purchase products from the commercial sector. The objective of this evaluation is to determine if actions taken by all three market sectors over the last five to seven years have increased condom use in an equitable and sustainable way in six African countries. - Total Market Approach: Lesotho
This case study describes the market for male condoms in Lesotho, and the roles of the public, social marketing, and commercial sectors in the market. - Total Market Approach in Six African countries
The Total Market Approach (TMA) is a system in which all sectors – public, subsidized and commercial – work together to deliver health choices for all population segments. In 2013, PSI completed six TMA case studies describing the condom markets in Botswana, Lesotho, Mali, South Africa, Swaziland and Uganda. These case studies also propose a set of recommendations for improving the effectiveness, efficiency and sustainability of condom markets. - How to Use the Inner Condom
Animated video on how to use the female condom or inner condom. Brought to you by Lovers+ and PSI/South Africa. - PSI’s Southern Africa Regional Platform Condom Social Marketing
PSI has a new regional condom brand in Southern Africa. Check out this video describing how the new program works. - 2012 Mid Year Region and Country Dashboards, Southern Africa
Mid-year Southern Africa region and country impact dashboards for 2012 - 2011 Region and Country Dashboards, Southern Africa
Southern Africa region and country impact dashboards for 2011 - Trust, Caution, and Condom Use With Regular Partners: An Evaluation of the Trusted Partner Campaign Targeting Youth in Four Countries
This article describes the Trusted Partner regional behavior change communication campaign and uses data from Lesotho, Mozambique, Uganda, and Zambia to evaluate the impact of the campaign on elements related to trust and condom use with regular partners by youth aged 15-24.