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“The work is hardest at the beginning” HOW KEY POPULATION PEER EDUCATORS AND PEER NAVIGATORS ARE DRIVING PROGRESS TOWARD EPIDEMIC CONTROL IN BURKINA FASO

Ending AIDS in West Africa (#EAWA) is a five-year project led by FHI 360 and funded by USAID with the goal of accelerating progress in the West Africa region toward UNAIDS’ 95-95-95 targets. Efforts are focused on improving access to prevention, care, and treatment services for female sex workers (FSWs) and men who have sex with men (MSM).
Since the launch of #EAWA in Burkina Faso in 2017, a total of 9,105 new individuals have been reached with HIV prevention interventions, 8,905 have been tested for HIV and received their results, and 801 have been newly diagnosed HIV positive. The overall case-finding rate is 9 percent, and 705 have been successfully linked to treatment (88 percent).
Results have steadily improved. During the most recent quarter (april to june 2019), the project achieved a 12 percent case-finding rate and a 95 percent link-to-treatment rate.
Much of Burkina Faso's progress toward UNAIDS' 95-95-95 targets can be attributed to #EAWA's tenacious peer educators and peer navigators.

“I am a former sex worker. When I heard about the peer educator training, I decided to come. I wanted to bring light to my friends… In one place, I met a newcomer – a 19-year-old Nigerian. [She] told me that she was not using condoms. I convinced her to use condoms and to get tested. Later, she thanked me and told me that I saved her life. We became friends. So, now, when I come for sensitization, she translates for me into English for the other sex workers who don’t speak French."

Irène Nakoulma, FSW peer educator

“We [peer educators] are doing the hard work, convincing people to come for an HIV test. Doing the test is the easy part. Often, they don’t want to come because they are afraid to know their status. They are afraid that if they are positive, other people will find out. They are also afraid that others will find out they are MSM."

Frank, MSM peer educator

“The hardest part of my job is convincing people to get tested. Some are stubborn. Some don’t know that HIV exists. Some are afraid of knowing their test results. It’s important to help them understand that their results will be confidential. Otherwise, they will not come."

Isabelle Tapsoba, FSW peer educator

“You have to be respectful of the sex workers [and] approach the work carefully. Don’t treat them any differently than anyone else. Little by little, you can earn their respect and trust. If you can convince one person to trust you, she can help convince the others to trust you as well.”

Epiphanie Tapsoba, FSW peer educator

PEER NAVIGATION

Peer navigation picks up where peer outreach leaves off. Peer navigators work full time as part of a case management team to assist HIV-positive key population members enroll in and access care and treatment services, while supporting them to identify and overcome barriers that interfere with achieving personal health-related goals.
Pictured below are peer navigators Eugenie Kinda, Romain Ouedraogo, Lucie Ouedraogo, and Touramakan Coulibaly.

“It’s hardest for people to be adherent at the beginning. They are afraid that someone will find out their status. We really have to help them understand that their information will remain confidential. The peer navigator’s work is hardest at the beginning of a diagnosis.”

Romain Ouedraogo, peer navigator

“When someone is not adherent, we do what we can to bring them back to the center. After the doctor has done his part, we talk with them about respecting appointments, we invite them to group talks so they can hear about others’ experiences and build trust in us, and we pay them visits to make sure they are taking their drugs."

Eugenie Kinda, Peer Navigator
The ultimate goal of peer navigators’ work is to help people living with HIV adhere to treatment so they become virally suppressed. Providers and peer navigators in Burkina Faso are working hard to improve uptake of viral load testing among clients on treatment. Of those who tested and received their results last quarter (april to june 2019), nearly 90 percent were virally suppressed.

“Sometimes you have to tell people that you were just like them before becoming a peer educator or a peer navigator… You have to relax, and help them relax. At first, they don’t want to talk to you. They are afraid. But they will once they understand that you were like them.”

The #EAWA project is proud to support Burkina Faso’s peer educators and peer navigators and thanks them for their incredible contributions toward ending HIV.

This story is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of FHI 360, and do not necessarily reflect the views of USAID or the United States government.