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Getting to PrEP Learning from Bahamas: Centering Care and Dignity in the Caribbean HIV Response - Salima Bacchus-Hinds (Guyana)

PANCAP-K4Health (with support from PEPFAR-USAID) aims to create important learning opportunities for agencies and civil society organisations (CSOs) within the Caribbean region. This is done in an effort to improve the HIV response, by building partnerships and sharing best practices and lessons learnt. I received an amazing opportunity to attend one of these exchanges in Bahamas (P.S., we need to have more meetings and training events in tropical countries. The weather, water and food is perfect!). I attended in my capacity as Programmes Manager of Guyana Responsible Parenthood Association (GRPA), a leading sexual and reproductive health NGO located in Guyana. For years, GRPA has been actively participating in the efforts to reduce HIV rates, through education, advocacy and service. GRPA is excited to play a role in the development of the next line of response to HIV in Guyana: PrEP.

The multi-country (Guyana, Jamaica, Trinidad & Tobago and Bahamas) team on Day 1, meeting at the Ministry of Health to officially open the exchange.

PrEP (Pre-exposure prophylaxis) has been in use in various countries for a number of years. In the United States, it received FDA approval in 2012. PrEP is just one tool, in a line of preventative measures, such as condoms, and lube, to help greatly reduce the risk of contracting HIV. For more info on PrEP, please click. PrEP was officially introduced to the Bahamas within the last 2 years. The exchange this week has been an opportunity to hear from the dedicated Bahamian team, learn from their strategy to introduce PrEP, educating the public and ensuring systems are working for their patients to encourage optimal wellness.

HIV testing outreach in a Nassau community

Campaign message to encourage safe sex

Poster: "Slide one on before you slide it in"

Sexual and reproductive health care is a completely new area for me. I was about the only person in the room without a medical background but I’m especially interested in advocating for the availability of PrEP in Guyana and educating the population on its benefits, and overall, how to protect themselves from contracting HIV and other STIs. While I enjoyed the stats, graphs and charts (who doesn’t love to see significant trends mapped out graphically?), I was especially struck by the obvious care and dedication of the HIV response team. Nurses, doctors, researchers, programme managers, everyone contributing, demonstrated a care not just for the overall programme, but for the well-being of the individual clients and patients that walked through their doors. Too often, it is easy for patients to feel faceless, nameless (just a client code) when seeking healthcare. We’ve all had issues of doctors that seemed to not hear you, that couldn’t even make eye contact or were easily dismissive of our concerns. The numbers speak for themselves: care, confidentiality, commitment means more adherent clients, and persons who are comfortable reaching out to know their status. I think ultimately, by centering care, HIV stigma will reduce, leading to outcomes that not only benefit HIV+ persons, but the communities that they live and work in.

One of the many faces of commitment: Nurse Morris

Other team members working during the outreach on Day 2

Visit to the clinic on Day 3

Feedback exercise from the Bahamian team on the introduction of PrEP and its management

I'm excited to play my role in initiating what was learnt over the 5 days in Bahamas. I think the visit has proven to be invaluable, not only for the information and science provided, but the connections that were developed. By day 4, I sat in the conference room, looking at all these brilliant, amazing, committed women and feeling completely reaffirmed about the work I do, and energised by the possibilities. I look forward to the expansion of PrEP, not only in Guyana, but throughout the Caribbean region. I look forward to seeing a model of care at the core of HIV interventions, where care isn't seen as exceptional, but the everyday practice for anyone interacting within the healthcare system. The Bahamian team has made a great case for all of this.

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Salima Bacchus-Hinds
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