HIV and TB Overview: Nicaragua

Background

Since 2003, CDC’s Central America Regional Office has partnered with the region’s Ministries of Health (MOHs) and the Council of Health Ministers of Central America. The union was formed to respond to the HIV epidemic.

CDC’s collaboration with these regional partners is focused on strengthening both strategic information and prevention strategies.

CDC also supports these countries to achieve the World Health Organization (WHO) End TB Strategy in the context of the United Nations Sustainable Development Goals Agenda.

HIV and TB data

HIV/AIDS

Tuberculosis (TB)

Key activities and accomplishments

Through the "Prevent New Infections Among Key Populations at Elevated Risk of Infection" strategy, CDC supports the implementation of sexually transmitted infection (STI) surveillance, prevention and control. The strategy is known as VICITS, by its Spanish acronym.

VICITS provides tailored HIV prevention and testing service packages to men who have sex with men, transgender women, and sex workers. This package includes:

• Risk-based counseling.
• Enhanced STI diagnosis and treatment.
• Condom and lubricant distribution.
• HIV testing.
• Peer navigation for linkage to treatment.
• A surveillance information system.

Increase knowledge of HIV status through active case finding strategies

CDC improves access to HIV testing among undiagnosed PLHIV by supporting active case-finding plans in CDC-supported departments. These include:

• Testing as part of outreach strategies for people at higher risk of HIV.
• Index testing services.
• Optimized provider-initiated testing.
• Community testing focusing on men.

Improve HIV-related health outcomes among PHLIV

CDC supports the provision of comprehensive service packages to increase adherence to HIV treatment and improve health outcomes among PLHIV. These comprise of:

• Active linkage to care after diagnosis.
• Re-engagement of PLHIV who are not in care or not virally suppressed.
• Early ART initiation.
• Treatment optimization.
• The management of opportunistic infections.

CDC advocates for introducing differentiated service delivery models. Some models include: pharmacy fast track refill (FTR), multi-month dispensing, and high viral load tracking and management at decentralized sites.

Strengthen sustainable viral load suppression among PLHIV to prevent illness and transmission

CDC supports viral load coverage and viral load suppression among PLHIV that receive clinical care in the supported sites by:

• Specimen referral.
• Supplies.
• Information.
• Quality management systems.
• Technology.
• Coverage of viral load services.

Increase the capacity of health care systems and the health workforce to serve people with HIV

CDC introduced the Extension for Community Healthcare Outcomes (ECHO) model. This innovative tele-mentoring initiative has expert teams lead virtual clinics. These clinics amplify the capacity for providers to deliver best-in-practice care to underserved people in their communities.

Through ECHO, CDC has created virtual communities of practice in HIV prevention, treatment, laboratory, mental health, and strategic information. Additionally, CDC launched the Continuous Quality Improvement Training Initiative. Participants learned how to apply concepts of quality improvement in the clinical setting to improve service quality.

CDC also established the HIV Rapid Test Continuous Quality Improvement Initiative and conducted economic evaluations to ensure optimal use of funding for programs. The programs deliver benefits to PLHIV and key populations and non-governmental organizations.

Resources

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