Thailand's Community-Based "Test and Treat" Initiative Offers Lessons and Opportunities

In 2012, the Thai Red Cross AIDS Research Centre began implementing a pilot “Test, Treat and Prevent HIV” initiative for men who have sex with men (MSM) and transgender (TG) population, which constitutes almost half of new infections in Thailand. When there was a need and opportunity to expand this initiative, USAID, through PEPFAR, stepped in to significantly scale up the implementation of the Test & Treat program. The study was expanded in 2014 with the objective of recruiting 8000 participants; 6000 from community-based organizations and 2000 from facility-based organizations. 

The objective under this phase was not just to increase the reach of Test & Treat per se, but specifically to look at a newer model for service delivery that is directed by the concept of ‘task shifting’. In the case of Test & Treat, this includes exploring the feasibility of implementing Test & Treat at drop-in-centers run by community-based organizations, as opposed to traditional settings such as hospitals and medical facilities. The data resulting from the cost-effectiveness analysis and modeling tool of this study will be presented to national stakeholders and donors and has the potential to contribute to recommendations that may be employed at the national level. This breakthrough model could result in a highly successful national program that could be replicated in neighboring countries or even beyond Asian borders.

This case study was submitted as part of USAID's CLA Case Competition, held in August 2015. Taken together, this collection of submissions illustrates the diversity of ways collaborating, learning, and adapting approaches are being operationalized in the field. Stringent judging criteria was used to determine official CLA Case Competition winners, so not all submissions should be considered an official USAID endorsement of best practice. To view all entries, visit the CLA Case Competition page.