CDC in Dominican Republic

CDC Dominican Republic implements PEPFAR activities by working directly with the Ministry of Health (MOH) to foster system-wide changes, and to support clinic-level activities currently focused on 10 HIV Clinics and two mobile clinics in three high HIV-burden provinces.

Clinical HIV Test and Start/Cascade: CDC has supported the country’s implementation of a system that allows the tracking of tested individuals and their link to care. The team expects to have an operating tool by 2020. CDC is working with the the Dominican Republic to expand the Test and Start strategy and create further awareness on how link-to-care can avoid lost to follow-up and strengthen the overall clinical cascade. CDC implemented a network model that will allow access-to-care to out of reach individuals, and help overcrowded sites by rolling out services in the community.

HIV Mobile Services: This initiative, known as mobile clinics, provides prevention and health care services, including HIV care prioritized by PEPFAR to the hard to areas in the provinces of Santiago and Altagracia. The Dominican Republic supplied reagents and antiretrovials for HIV to use in intervention activities aimed at prioritized populations.

Multi-Month Dispensing (MMD): CDC is working with the Dominican Republic and civil society to increase multi-month dispensing uptake and scale the strategy to non-prioritized PEPFAR sites.

Pre-exposure prophylaxis (PrEP): is currently implemented among Key Populations such as men who have sex with men and female sex workers. PrEP has been widely accepted by its users prompting the country to expand available sites and services.

Co-Infection Tuberculosis (TB)/HIV: CDC provides technical assistance in three primary areas:

1. 1. Ensuring clinics are accurately collecting and reporting TB and TB-HIV co-infection data
   2. Working closely with the Dominican Republic to expand Isoniazid Preventive Therapy (IPT) in PEPFAR and non-PEPFAR sites. The demand increased as health workers scaled-up IPT as part of a full-fledged HIV comprehensive care package. In previous years IPT uptake was low and its role not fully understood
   3. Building surveillance and epidemiological capacity through the National TB Patient Monitoring System.

CDC supports the Ministry of Health in characterizing its HIV/AIDS epidemic by assisting in the development and implementation of the National HIV Patient Monitoring System. This system collects critical information to describe HIV risk factors, characterize key populations, and assess the HIV cascade. CDC also supports the HIV Testing Monitoring System, the first nominal HIV testing registry implemented to monitor of patients living with HIV, and to serve as data source for PEPFAR indicators and the national response.

CDC works to scale-up viral load (VL) testing in all patients on antiretroviral therapy (ART) and to strengthen the quality of laboratory services to provide accurate and reliable CD4 count (T-cell count) and VL testing. CDC provides technical guidance to the MOH to comply with International Health Regulations by increasing laboratory capacity, establishing a robust public health laboratory network, and improving the laboratory’s role in disease surveillance. CDC also supports laboratory response to infectious disease outbreaks, surveillance activities, and other emergencies.

Infectious diseases can emerge without warning and quickly spread in our globally connected world. CDC works with the Dominican Republic to help build surveillance and laboratory capacity to detect and respond to infectious diseases such as cholera, chikungunya, and Zika.