Guyana

Key Results

In 2020-2021, the Joint Team in Guyana partnered with various stakeholders to scale up sexual and reproductive health and HIV education and services among adolescent and young people, including adolescent mothers in targeted administrative regions through awareness raising campaigns, community dialogues and training of healthcare workers. School teachers and peer educators were also trained to improve the quality of comprehensive sexuality education. The Joint Team supported peer navigators to provide psychosocial services for mothers and children living with HIV; and implemented food support and antiretroviral treatment delivery programmes to improve their access and adherence to treatment. In collaboration with the Government and civil society organisations, integrated gender-based violence and sexual and reproductive health services were expanded to survivors of violence and their families in health facilities and humanitarian settings as well as during the COVID-19 pandemic. Various community members, including survivors of gender-based violence were sensitized on how to access available services while law enforcement officers were trained to improve their understanding of human rights and HIV.

HIV prevention among young people and key populations

The Ministry of Health was assisted technically by the Joint Team in developing the Adolescent and Youth-Friendly Health Service Delivery Standards and Adolescent Health Services Delivery Guidelines which include the delivery of quality sexual and reproductive health and HIV services for adolescent and young people in Guyana. These documents were subsequently integrated into the Government’s Family Health Manual and improved action plans were made available in targeted healthcare facilities in two administrative regions (Barima Waini and Upper Takutu- Upper Essequibo). Technical support was further provided to revise the action plans based on the adolescent health standards in eight health facilities.

Under the India-UN Development Partnership Fund, the Joint Team supported the Ministry of Health to provide sexual and reproductive health education and services and disseminate information on integrated gender equality and gender-based violence prevention and response reaching 7000 adolescent boys and girls in selected secondary schools in the above-mentioned administrative regions. Additionally, 100 adolescents were trained as peer educators while 58 healthcare workers received capacity building training on the delivery of sexual and reproductive health services.

The Adolescent Health Unit at the Ministry of Health was assisted to expand its adolescent health programme and services to rural and hinterland communities in two administrative regions (Pomeroon-Supenaam and Potaro-Siparuni). A total of 15 peer educators were also trained to support health centres in the implementation of programmes tailored for adolescent mothers and general adolescent health services.

The Guyana Responsible Parenthood Association was supported to expand HIV combination prevention and sexual and reproductive health services for vulnerable young people and key populations in Demerara-Mahaica and Essequibo Islands-West Demerara regions. These services were also offered to Venezuelan migrants and refugees and Guyanese migrants returning from Venezuela who face several hurdles in accessing sexual and reproductive health services, such as discrimination, lack of resources, language barriers, and a lack of knowledge about available services. Overall, the initiative reached 1370 young people and women, and 517 individuals form the LGBTI community.

The Joint Team also collaborated with the Guyana Responsible Parenthood Association for the recruitment of five peer educators and two peer navigators to provide risk reduction sessions and referral support. The peer educators and navigators were responsible for providing beneficiaries with information on the prevention of HIV and other STIs; guidance on how to access health services; and referrals for testing, treatment and care of HIV and STIs, and other health services. Male and female condoms were distributed during demonstration sessions.

In addition, the Guyana Responsible Parenthood Association conducted a social media campaign, which reached 9643 people on Facebook and Instagram, promoting HIV combination prevention in youth-friendly services. The campaign was also used to sensitize relevant stakeholders, including healthcare providers on the rights of adolescents and young people from key population groups to access sexual and reproductive health services in line with the recently approved national sexual and reproductive health policy. Additionally, with financial and technical support from the Joint Team, several training and awareness raising workshops were conducted reaching more than 120 adolescents and young people to improve their knowledge around HIV, sexually transmitted infections, sexual and reproductive health, and life skills.

To improve the delivery of quality comprehensive sexuality education in Guyana, the Joint Team supported capacity building sessions for 35 teachers and school-based peer educators; group dialogue sessions for 60 men and boys in eight targeted communities; awareness raising sessions that reached 100 parents and 50 community and traditional leaders and council members; and community parenting and support groups engaging 500 Parent Teacher Association members in four of the eight targeted health facilities. These initiatives further benefited an estimated 6000 people, such as the residents of the project implementation area.

HIV treatment and support

To mitigate the impacts of the COVID-19 pandemic, the Joint Team supported the distribution of antiretroviral therapy to ensure continued access to medicines and follow up of people living with HIV on treatment. Support was also provided in 2021 to train three case navigators to provide psychosocial support to mothers and children living with HIV, especially pregnant women and mothers living with HIV who defaulted from care and treatment.

In partnership with the Family Awareness Consciousness Togetherness (FACTS), the Joint Team provided food baskets for 80 people living with HIV and their families whose livelihoods were severely affected by the COVID-19 pandemic in region 6 (East Berbice – Corentyne). Additionally, 470 people living with HIV and persons from key populations and LGBTI community received nutritional support through a partnership with the National AIDS Programme and the Society Against Sexual Orientation Discrimination (SASOD) during the pandemic.

Source: Global AIDS Monitoring

AIDS mortality

Source: Global AIDS Monitoring

Progress towards 95-95-95 targets

Source: Global AIDS Monitoring

Human rights, gender inequality and gender-based violence

The Joint Team assisted the Government to update the mapping of gender-based violence services and referral pathways in the context of the COVID-19 pandemic to improve delivery of integrated sexual and reproductive health, HIV, and gender-based violence services in health facilities and emergency settings. The updated referral pathways are awaiting formal approval and official launch by the Government of Guyana.

The Caribbean Disaster Emergency Response Management Agency (CDEMA) was supported to conduct impact assessments of flooding on health service delivery, including regarding the access to integrated sexual and reproductive health and gender-based violence services in regions affected by unprecedented floodings. The findings and recommendations were shared with the Government to inform emergency preparedness and response efforts, especially with respect to sexual and reproductive health and gender-based violence service provision.

In 2021, the National AIDS Programme Secretariat was assisted in training 100 (46 females) police officers from nine of the 12 police divisions in Guyana to improve their understanding of human rights and HIV and to enhance their capacity to deliver legal and security services for people living with HIV and key populations. The training complemented regional efforts aimed at engaging judges from the Caribbean sub-region on issues relating to human rights, HIV, and the law.

As part of its COVID-19 response, the Joint Team assisted 11 civil society organizations to expand safe gender-based violence services and psychosocial support to 116 women and girls, including 15 adolescent girls and mothers during the COVID-19 pandemic. Additionally, 33 community personnel, such as pharmacists and shop owners were trained to strengthen access to gender-based violence referral information at community levels. In 2021, a total of 71 survivors of gender-based violence and their families, including groups facing multiple and intersecting forms of discrimination, were sensitized on how to access support services, including longer-term recovery services.

In commemoration of the 16 days of activism against gender-based violence, the World AIDS Day, and International Day of Persons Living with Disabilities, the Joint Team supported various public sensitization initiatives. For example, the Guyana Council of Organizations for Persons for Persons with Disabilities was assisted to hold discussions with women and girls with disabilities on the prevention of gender-based violence as well as the available services for survivors of violence.

Contribution to the integrated SDG agenda

Under the 2017-2021 United Nations Multi-Country Sustainable Development Cooperation Framework (MSDCF), the Joint Team actively contributed to the realization of the Sustainable Development Goals (SDGs) and the 2030 Agenda. For instance, contributing towards SDG 3 (Good Health and Wellbeing), the Joint Team and the Guyana Responsible Parenthood Association supported the Ministry of Health for the procurement of modern contraceptives and other reproductive health commodities for eight health facilities strengthening access to quality sexual and reproductive health and HIV services among harder to reach hinterland communities, including adolescent and young people, survivors of gender-based violence, and Venezuelan migrants.

Challenges and lessons learned

The COVID-19 pandemic was the main challenge in the HIV response, which led to the reprogramming of HIV resources for COVID-19 related initiatives in 2020, cancellation of planned activities, and the restriction of non-essential travels in-person programmes, especially initiatives targeting vulnerable and key populations, including people living with HIV.

The pandemic further amplified inequalities, stigma, and discrimination, and had a direct impact on HIV and sexual and reproductive health programming and service delivery. Experiences demonstrated the need to intensify support to nongovernmental organizations, such as the Guyana Responsible Parenthood Association to implement innovative and cost-effective service delivery approaches aimed at scaling up access to and uptake of combination HIV prevention, testing, and treatment services for young people and key populations during the COVID-19 pandemic. In addition, lessons from community engagement initiatives led in 2020-2021 further underscored the need to improve access to sexual and reproductive health, HIV, and gender-based violence services for marginalized communities which were further impacted by COVID-19 pandemic containment measures.

Conservative beliefs and criminalization of sex work and sexual relations between men in Guyana continued to encourage strong opposition and pushback on the implementation of HIV programmes targeting the LGBTI community. Lessons learned showed that implementation of behavioural change programmes, particularly in relatively conservative communities with strong culturally driven behaviours, requires sustained interventions to achieve meaningful change. It also requires the support of key stakeholders in targeted communities.

Finally, lack of financial resources continued to impede the implementation of the Stigma Index 2.0 study among people living with HIV.