HIV cascade assessments are increasingly being used to diagnose both barriers and solutions to ensuring the optimal flow of KP beneficiaries through the HIV prevention, care, and treatment cascade. To date, joint cascade assessments have been conducted in Malawi, Cameroon, Swaziland, Haiti, Angola, Nepal, Botswana, and Cote d’Ivoire. USAID/Botswana requested a joint technical support visit with GF and the Botswana MOHW to assess the strengths and weaknesses of the HIV prevention, testing, treatment, and viral suppression cascade among MSM and FSWs and make recommendations on improving the cascade in Botswana.
The joint visit was conducted from September 21 to 28, 2017. The cascade assessment investigated challenges and successes associated with reach, test, links to care and treatment, treatment, viral load (VL), crosscutting topics (e.g., violence prevention and response [VPR], commodities), and monitoring and evaluation (M&E). The assessment took place in Gaborone, Selebi-Phikwe, Maun, Francistown, and Greater Francistown. The aim was to align and harmonize the GF and PEPFAR KP programs.
In collaboration with the government of Botswana (GoB), PEPFAR and GF are aligning and consolidating approaches toward achieving epidemic control, particularly for FSWs and MSM. These efforts are implemented through the LINKAGES project, which is supported by USAID and PEPFAR, and ACHAP, which is funded by GF. In addition, the Dutch government-supported Bridging the Gaps program (implemented by COC Netherlands) and GF- supported KP REACH project (via Hivos) have also joined the alignment process. The introduction section of this report provides more details about these projects. The Cross Border Initiative, implemented by North Star Alliance through GF funding to South African Development Committee (SADC), was also visited by the assessment team.