Supporting 'hidden' HIV groups in the Middle East and North Africa

A new case study documents a successful capacity-building project in the Middle East and North African (MENA) region, home to one of the world's fastest-growing HIV epidemics.

In 2013, the Alliance received funding from the United States Agency for International Development (USAID) under the Management Sciences for Health (MSH)-led Leadership, Management & Governance (LMG) Project to strengthen the greater involvement of people living with HIV (GIPA) in four MENA countries: Algeria, Lebanon, Morocco and Tunisia.

It was the first time that nascent organisations or support groups of people living with HIV in Algeria, Lebanon and Tunisia had received regular technical and financial support from an international NGO to lead targeted HIV care and support projects, implemented by and for people living with HIV.

Technical assistance

GIPA treeOver three years, the Alliance provided tailored technical assistance to AMEL (Algeria), Vivre Positif (Lebanon) and GS++ (Tunisia) to build their capacity in project design and management, centred on the needs of people living with HIV. This was achieved in liaison with its longstanding partners Association de Protection Contre le SIDA (APCS), Soins Infirmiers et Développement Communautaire (SIDC) and Association Tunisienne de Lutte contre les MST SIDA (ATL).

The case study, Nourishing the GIPA tree in MENA, reports that the HIV situation in MENA is concerning. While the region has one of the world’s fastest-growing HIV epidemics, access to antiretroviral therapy (ART) for people living there is the world’s lowest.

In 2014, it was estimated that 240,000 people in MENA were living with HIV and an estimated 22,000 new HIV infections occurred that year. AIDS-related deaths more than tripled in the region between 2000 and 2014.

Barriers to HIV prevention, care and support

Deeply rooted HIV-related stigma in MENA, and discrimination at all levels of society, pose significant barriers to HIV prevention and care, and support, as well as the engagement of people living with HIV. As a result, most people living with HIV in the region remain hidden.

Nourishing the GIPA tree in MENA documents many successful interventions including:

  • In Algeria, AMEL volunteer femmes relais (female mediators) oriented people living with HIV towards HIV care and support services. They provided psychosocial support to women living with HIV, distributed boxes of formula milk to babies affected by HIV, and covered the costs of laboratory tests for women living with HIV.
  • In Tunisia, GS++ volunteer accompagnateurs socio-sanitaires (socio-medical escorts) reached out to people with HIV who had become lost in the follow-up process. They received care and support services, including psychosocial support, social services, legal assistance and nutritional support (provided under the Global Fund grant).
  • In Lebanon, Vivre Positif volunteers reached thousands of young people in schools, campuses, workplaces and public beach areas with positive prevention and HIV-related stigma and discrimination reduction messages. They also ensured that people living with HIV received HIV treatment literacy education. At the health service delivery level, project partners worked with healthcare providers, successfully raising awareness about the specific needs of people living with HIV in order to reduce the stigma they face in health settings and ensure that the necessary laboratory equipment, medications and guidelines were available to improve access and adherence to antiretrovirals (ARVs).
  • In Morocco, Alliance Linking Organisation AMSED led national-level advocacy activities to mobilise the national stakeholders of the HIV response towards greater and more meaningful engagement with the GIPA principle and the Positive Health, Dignity and Prevention approach. An exploratory mission on the involvement, care and support of people living with HIV within the national response and a national forum on GIPA principles resulted in clear recommendations for moving forward in this area.

The case study is intended for funders, public sector policy- and decision-makers and programme managers from civil society, committed to preventing HIV and improving the lives of people living with HIV in the MENA region.

The report’s findings are based on interviews with representatives of the organisations and self-support groups of people living with HIV in Algeria and a field visit to Tunisia in December 2015.