About this Project
LINKAGES was a 5-year USAID funded key population project that was implemented in Malawi by FHI 360 as a prime recipient and Pakachere IHDC, CEDEP and MACRO as sub-recipients. Pakachere IHDC implemented the project in Lilongwe, Mzimba, Blantyre and Mangochi Districts in Malawi. The project implemented a set of interventions to reduce HIV transmission among Female Sex Workers (FSW) and improve the quality of life of FSW with HIV. The project used activities that demonstrated marked improvements in access to and uptake of HIV testing, care, support and treatment services.
HIV Cascade Model
LINKAGES used the HIV services cascade model that illustrates how individual should ideally move through the continuum of HIV prevention care and treatment services to reduce HIV transmission as well as ensure high quality of life. The project emphasized intervention stages of reach, test and treatment services as key steps to ensure long-term ART adherence that results in viral load suppression.
Project Activities
The project delivered a comprehensive package of services that included Peer education, HIV testing services, Gender Based Violence (GBV) services and referrals, Condom and lubricants distribution and promotion of use, STI screening and management, cervical cancer screening and referrals, family planning services and TB screening. The package was delivered through 12 Drop in Centres, outreach clinics and referrals to public facilities.
The LINKAGES legacy
Pakachere through LINKAGES achieved the following:
• Supported over 13,000 Female Sex Workers with comprehensive HIV prevention packages.
• Facilitated the establishment of 12 Drop-in-Centres which are safe spaces for female sex workers delivering clinical and non-clinical services.
• Increased uptake of HIV testing services with over 5000 female sex workers tested in the final implementation (2019)
• Supported 6,859 female sex workers living with HIV with ART and psychosocial support at community level through peer navigation.
• Improved STI case detection from 49% in 2016 to 27% in 2018. Efforts need to continue to reduce this further.
• Strengthened ART linkage rates from less than 50% in 2015 to over 96% in 2019
• Strengthened GBV reporting and response across the years with 103 FSWs supported with post violence services in 2019 alone.
• Across the 5 years of implemented, 12,300,000 male condoms, 360,000 female condoms and 2,300,000 condom compatible lubricants were distributed among populations that need them most.
• Key Population leadership was enhanced through peer educator, peer navigator and outreach worker trainings in microplanning, GBV and other capacity areas