Ecuador

Key Results in 2022-2023

Combination HIV prevention, including pre-exposure prophylaxis (PrEP) and testing services, was expanded through healthcare trainings on integration of services and engagement of communities.
Community-led initiatives were scaled up to better inform adolescents and young people on HIV and sexual and reproductive health and rights.
Over 500 people, including health professionals were reached by a campaign to address stigma and discrimination.

Joint Programme Results

With the Joint Programme’s strategic support in 2022-2023, Ecuador made considerable progress in scaling up integrated HIV services for key populations while building national capacity for the prevention of stigma and discrimination. By the end of 2023, PrEP was implemented in 14 service centres, including two community-based sites, enrolling over 1400 people from key populations. PrEP was included in the national healthcare registration platform; and 80 healthcare providers received training on the delivery of integrated and differentiated combination HIV prevention services, including PrEP, HIV self-testing, rapid treatment initiation and management of advanced HIV disease. HIV and hepatitis screening was also strengthened through the revision of the national HIV self-testing guidelines and the assisted partner notification protocol; as well as through the procurement of 500 HIV self-testing and 60 000 rapid hepatitis B and C testing kits (WHO).

Community surveillance networks were strengthened in the four provinces of the Northern Border with Colombia—Carchi, Esmeraldas, Imbabura and Sucumbíos. In Guayaquil, 200 trained community health volunteers facilitated identification and HIV testing of 631 pregnant women, and supported their referrals to healthcare facilities as part of a community-led response implemented in collaboration with the nongovernmental organization Desarrollo y Autogestión. Over 2450 pregnant women were also sensitized on the prevention of vertical transmission of HIV, while 185 people living with HIV, primarily pregnant women, children and adolescents received psychosocial support (UNICEF).

HIV incidence per 1000 uninfected populations

Source: AIDSinfo

AIDS mortality per 1000 population

Source: AIDSinfo

Progress towards 95-95-95 targets

Source: AIDSinfo

With the Joint Programme’s support, the MoVIHlízate youth-led working group created in Quito-Pichincha in 2018 continues to promote and coordinate spaces for a comprehensive and intersectoral HIV response. Currently, a total of 6800 people, including people living with HIV, indigenous people and Afro descendants in five cities composes MoVIHlízate; they have access to information on HIV and health services, social protection programmes and human rights (UNICEF, UNFPA). A community school for the training of trainers on health, including HIV and human rights was also established to educate young people residing in border and cross-border areas. In Guayaquil, 1320 young people were sensitized on HIV prevention, sexual and reproductive health and human rights. In addition, 115 trained young people reached 474 adolescents, young people, sex workers and people from the LGBTQI+ community through innovative workshops on HIV and sexual and reproductive health. Finally, integrated comprehensive sexuality education and HIV prevention services benefited 1633 adolescents and young people in Esmeraldas, Guayas and Morona Santiago through technical support from the Joint Programme (UNFPA).

In May 2023, the Yo No Discrimino campaign was launched to address stigma and discrimination in Ecuador. As a result, more than 500 people, including healthcare providers and community leaders increased their awareness of stigma and discrimination that prevent people living with HIV and key populations from accessing HIV services. Besides, 150 health professionals participated in experience- sharing workshops on stigma and discrimination organized in collaboration with the Ministry of Health and the nongovernmental organization Matices across the country (UNFPA, WHO).

Through the Soy Clave project and other programmes funded by the Global Fund, the Joint Programme partnered with the Government to increase sustainability of community-led services. This included the development of a sustainability roadmap for community-led services via social contracting; and the capacity building of several community-based organizations to rollout the first pilot social contracting programme expected in 2025 (WHO, UNAIDS Secretariat).