Photo Caption: Front row seated, extreme right, Dr. Shanti Singh-Anthony, Knowledge Management Coordinator, PANCAP, second from right, Ms. Sandra Jones, centre, Dr. Omar Sued, second from left Dr. Joel Palefsky, left Dr. David E. Koren, along with participants of the USAID-funded PANCAP training for regional HIV Clinicians addressing opportunistic infections in people living with HIV.

Tuesday, 5 September 2023, (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), the mechanism that provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, hosted a two-day regional training programme funded by USAID, for HIV clinicians, addressing opportunistic infections in people living with HIV, from August 24-25, 2023, in the Republic of Trinidad and Tobago.

Presentations were made by several technical experts from PANCAP, the Pan-American Health Organisation (PAHO) and other experts from within the field of medical academia. The overall objective of the training was to increase the capacity of HIV practitioners in the region to detect and manage common opportunistic infections that affect people living with HIV (PLHIV) in the Region.

To set the tone for the meeting, Dr. Shanti Singh-Anthony, Knowledge Management Coordinator, PANCAP, discussed the status of the Caribbean response, noting that there has been significant progress with a 15% reduction in new infections and a 53% reduction in AIDS-related deaths in the last ten years. Despite these achievements, there continue to be challenges that as a Region we must address to achieve our common goal of ending AIDS. Specifically, it is noted that more than 25% of PLHIV enter into treatment programmes with advanced HIV infection and opportunistic infections with implications for morbidity and mortality as well as for HIV transmission. The adequate management of opportunistic infections will improve the quality of care to PHLIV. World Health Organisation (WHO) guidelines were used to update participants on the management of Tuberculosis, Histoplasmosis, Cryptococcal disease, Human Papilloma Virus and cancers.

The training underscored the impact of HIV on key populations in the Region and the role of stigma and discrimination that hinders access to treatment. To address this a session was focused on health care workers delivering competent healthcare. The session delved into the components of a sexual health history and provided tips for facilitating patient-focused discussions on sexual health and promoting sexual health and wellness among sexual and gender-diverse populations.

The importance of using a highly efficacious treatment regimen as recommended by WHO was emphasized.  An update was provided on treatment for adults and children living with HIV with optimized first-line therapy using Dolutegavir. Belize shared their experience including successes and lessons learned in transitioning their cohort of children living with HIV to first-line therapy with dolutegavir.

PAHO presented an update on the initiatives around the elimination agenda focusing on the elimination of mother-to-child transmission of HIV, congenital syphilis and hepatitis B. Countries-specific initiatives were shared. Guyana described their success in treating persons with Hepatitis C virus, and Jamaica AIDS Support for Life discussed the impact of their Hepatitis B programme for key populations.

Pre and post-test questionnaires were administered to participants at the start and end of the training exercise respectively, to assess the knowledge gained. It was revealed that 100 percent of the participants in attendance were in agreement that new knowledge was gained.  All the participants agreed that they would apply the knowledge gained and also agreed that they would share the knowledge gained from this training programme with their colleagues and peers.

Commenting on the success of this training exercise Dr. Shanti Singh–Anthony Knowledge Management Coordinator, PANCAP said, “This training programme forms part of PANCAP’s continuous capacity-building efforts aimed at enhancing the quality, effectiveness, efficiency, equity, and sustainability of all HIV clinical services and related non-clinical support services being offered to PLHIV within the CARICOM region. Moving forward, we intend to broaden the scope of the training to encompass a wider diversity of healthcare workers in order that they will be better equipped to deliver more sustained, efficient, and equitable health outcomes to PLHIV within the region.”

Participants in the workshop included HIV physicians from Barbados, Belize, Dominica, Grenada, Guyana, Jamaica, Saint Lucia, St. Kitts and Nevis, St. Vincent and the Grenadines, the Republic of Trinidad and Tobago and Suriname who are providing care and treatment for persons with HIV.