ThaiNGO

Terms of Reference

Consultants and Project Assistants in Epidemiology and Strategic Information

Thai HIV Epidemic Consensus Meeting and Report

USAID LINKAGES Project

FHI 360

About FHI 360

FHI 360 is a non-profit human development organization dedicated to improving lives in lasting ways by advancing integrated, locally driven solutions. FHI 360 staff includes experts in Health, Education, Nutrition, Environment, Economic Development, Civil Society, Gender, Youth, Research and Technology; creating a unique mix of capabilities to address today's interrelated development challenges. FHI 360 serves more than 60 countries, all 50 U.S. states and all U.S. territories.

Background

LINKAGES is an USAID-funded project managed by FHI 360 aimed at accelerating the HIV/AIDS response in Thailand to reach, test, treat and retain key populations in HIV prevention, care, and treatment services (the HIV cascade). The project focuses primarily on men who have sex with men (MSM) and transgender (TG) women. LINKAGES Thailand supports community-based (CBO) and non-government organizations (NGO) and closely collaborates with national and local government organizations (GO) and health care providers and facilities to implement key strategies and activities to ensure effective linkages, engagement and retention of key populations across the HIV cascade. These interventions are currently implemented in Bangkok, Chiang Mai, Chonburi and a few additional Thai provinces. Besides LINKAGES, several other international organizations and local bodies support or implement aligned or different HIV related interventions targeting MSM and TG women. Like programs supported by LINKAGES, these projects usually collect their own individual monitoring and evaluation data. On the national and provincial level, GOs (such as the Bureau of Epidemiology of the Ministry of Public Health and the AIDS Division of the Bangkok Metropolitan Administration) conduct regular (biennial) integrated behavioral and biological HIV surveillance (IBBS) in key populations, including MSM and TW. Apart from these, HIV program service data (HIV testing, linkages and access to antiretroviral treatment, PrEP, and related outcomes) are collected by NGOs providing these services and public hospitals. Summaries of these data are available from the MOPH through its National AIDS Portal (NAP) system as well as organizations and donors who support local NGOs such as the LINKAGES project managed by FHI 360 and Raks Thai Foundation that manages Global Fund-supported NGOs.

In recent years, biomedical HIV prevention methods, such as antiretroviral (instant or early) treatment for prevention (in HIV-infected individuals) and HIV pre- and post-exposure prophylaxis (for those exposed or at high risk for HIV infection) have been added to the spectrum of HIV preventive services offered to MSM and TW. Besides IBBS and programmatic activities and their monitoring and evaluation, a wide variety of behavioral, epidemiological and clinical research studies, demonstration and pilot projects have or are being been conducted during the past decade. Each and all these activities aim to contribute to the understanding, prevention and control of the HIV epidemic in MSM and TW in Thailand. However, data are often collected in different designs and for different purposes (for example, monitoring and evaluation versus scientific research), targeting varying sub-populations, calendar periods, and outcomes. Coverage and methodologies may differ between agencies and over time. Quality, consistency and extent of data obtained from service providers may be limited. Disaggregation of information by risk group or sub-population may not always be available or possible. Statistical analysis of data varies from cross-sectional and descriptive to longitudinal and multivariate. Result may be published in reports or in the scientific literature, in Thai or English, or may not be reported at all. Because of this variety in data-sources, approaches and dispersion of results, the current state of the HIV epidemic in MSM and TG in Thailand remains unclear and it is unknown to what extent current efforts impact its overall course.

Purpose of Assignment

The purpose of this assignment is to bring together agencies, sponsors, researchers, stake-holders and MSM and TG women community representatives to review, discuss and reach consensus on the current state of the HIV epidemic among MSM and TW in two major HIV epicenters, Bangkok and Chiang Mai, Thailand and the impact of existing HIV prevention and treatment services.

Scope of Work

The below key activities will be conducted by the consulting team, with assistance provided to them by the USAID-supported LINKAGES Project, managed by FHI 360:

• Establish a consensus meeting working group with representatives of GO and NGO agencies, national and international sponsors, clinicians, researchers, and community representatives involved in HIV policy, planning, implementation, monitoring and evaluation, research and service delivery for MSM and TW. The task of the working group is to identify and review HIV epidemic indicators (see annex for suggestions) vis-à-vis latest size estimates in Bangkok and Chiang Mai, their sources and gate-keepers, and mobilize this information for presentation and review during the consensus meeting.
• Create a meeting secretariat to assist in identifying and approaching working group members, managing and organizing preparatory consultations, collecting resource materials for review by the working group, identifying and contacting relevant speakers and discussion panel members, developing and finalizing the meeting agenda and extend invitations to contributing agencies and their representatives.
• Organize and conduct a one-day HIV epidemic consensus meeting, including presentations of epidemic indicators, followed by an expert-panel discussion, and leading to conclusions and recommendations.
• Prepare the HIV epidemic consensus report, outlining background and purpose of the consensus meeting, present the agenda, summarize presentations, review outcomes and formulate conclusions and recommendations.

The combined scope of work will bring Thailand closer to answering the following questions:

1. Are HIV incidence among MSM and TG increasing or decreasing based on available data in Chiang Mai and Bangkok? What appear to be the driving factors of continuing incidence?
2. How well are services targeting MSM and TW women as a whole reaching 95-95-95 targets in Chiang Mai and Bangkok?

Other questions will be determined in the early phase of the project.

Qualified applicants

FHI 360 is seeking qualified applicants to fulfill this scope of work, including 1) senior level consultants in epidemiology and strategic information and 2) project assistants (bilingual, Thai and English). The Senior Consultants will have experience and expertise in Thailand’s HIV epidemiology as well as high level knowledge of programs targeting MSM and TW in Thailand and a doctoral level degree, preferably MS or PhD. The Project Assistants will have experience in HIV research methods and data analysis, including a degree in public health, epidemiology, or a related field at the Masters level.  

The duration of the contract is about 6 months, starting on or around June 1, 2018 and ending in December 2018. The projected level of effort is expected to be approximately 14 weeks during this time period, though FHI 360 reserves the right to adjust levels of effort depending on the number of consultants and project assistants hired.

Deliverables

• Bi-weekly tentative schedule and updates
• Bi-monthly memo listing activities and key next steps
• Establishment of HIV epidemic consensus working group and listing of its members
• Agenda and minutes of preparatory working group meetings (two-monthly)
• Proposed date, venue, list of speakers and panelists, agenda and invitations for the consensus meeting
• Summary report from the meeting, including conclusions and recommendations

Supervision provided

The team will work under the direct supervision of LINKAGES Thailand staff. LINKAGES may assign one senior consultant to supervise the team on a day-to-day basis.

How to apply

Please send your CV and consultancy rate to hr.thailand@fhi360.org by May 6, 2018

Applicants should eligible to work in Thailand.

Place of Work and Travel Involved

The team will work from home and at FHI 360, where office space and computer access will be provided. The team will organize their working hours based on the needs and progress of the project. A tentative schedule should be planned by the consultant and assistant (after consulting the LINKAGES APRO) every month. The timeline and project updates should be submitted to and discussed with the supervisor in charge of project management.

Official travels may be required around Bangkok to engage and brief stake-holders and contributors to the project and to attend working group meetings. LINKAGES will reimburse the consultant all expenses associated with such travel based on USAID policies and rates.

Annex 1 HIV epidemic indicators (examples)

1. HIV prevalence and incidence (including acute HIV infection) among MSM and TW in research studies
2. HIV prevalence and incidence among MSM and TW at HIV or STI testing sites
3. HIV prevalence among MSM and TW included in IBBS
4. Population size of MSM and TW
5. Number of MSM and TW living with HIV infection
6. Number of MSM and TW linked to care, on antiretroviral treatment (ART) and virally suppressed
7. Number of CD4+ cells among MSM and TW when first testing HIV infected, when linked to care and when starting ART
8. Number of MSM and TW taking ART pre-exposure prophylaxis (PrEP)
9. Proportion adherent among MSM and TW taking PrEP
10. Proportion of MSM and TW reporting multiple sex partners, anal intercourse and inconsistent condom use
11. Proportion of MSM and TW engaging in unprotected anal intercourse with HIV infected men or with men of unknown HIV serostatus
12. Proportion of MSM and TW having ever been tested for HIV infection
13. Proportion of MSM and TW having been tested for HIV infection during the past year
14. Proportion of MSM and TW reporting ever having used recreational drugs
15. Proportion of MSM and TW reporting ever having used recreational drugs during sex
16. Proportion of MSM and TW reporting ever having injected drugs
17. Proportion of MSM and TW reporting ever having injected drugs during sex
18. Number of MSM and TW diagnosed with rectal gonorrhoeae
19. Number of MSM and TW diagnosed with any STI