“So here are these two countries in the Caribbean, both pursuing a similar study, both benefitting from CDC funding, and both having the opportunity to really reflect on the commonalities and the differences in our experiences. So I think this was very, very powerful. There was not one person giving here at all, but we were all giving and taking and learning and moving.” – Tracie Rogers, NASTAD Study Lead in Trinidad and Tobago
This past September, Quialashon Sands of Nassau, Bahamas, took her first trip to Trinidad and Tobago. Her destination was Port of Spain, where she spent one week meeting with and learning from Tracie Rogers, who has been the NASTAD Study Lead in Trinidad and Tobago since 2011. Quia is the new NASTAD Study Lead in The Bahamas, and both she and Tracie are working to support the Ministries of Health in their home countries to implement surveillance systems for populations at greater risk for HIV, using biological and behavioral surveillance studies (BBSS). Biological and behavioral surveillance studies focus on learning more about HIV and risk behaviors within certain key populations. As such, BBSS complement case-based surveillance systems and allow for a greater understanding of the local epidemic, helping to guide and target prevention, treatment and care programs and resources. Because both Tracie and Quia are supporting BBSS development and implementation, NASTAD recognized an opportunity for peer-to-peer capacity building, a framework that NASTAD implements regularly in its global work. This peer-to-peer capacity building allows for local experts to learn from one another’s experiences, enhances local leadership to plan, manage and evaluate evidence-based HIV programs, strengthens organizational capacity, and creates sustainability for effective programs. The peer-to-peer approach often involves collaboration between NASTAD’s membership of U.S. state AIDS directors and local (in country) partners, and the benefit is bidirectional. For example, staff from the Seattle/King County public health department’s Communicable Disease Epidemiology and Immunization Section provided technical assistance to Ministry of Health and NASTAD staff in Trinidad and Tobago to help successfully develop and implement the BBSS. However, as local capacity has grown, NASTAD has been able to support and use a “South-to-South” technical assistance (TA) model. Using the South-to-South TA framework, NASTAD facilitated peer-to-peer capacity building within the Caribbean region in arranging for Quia to travel to Port of Spain so that she could learn about BBSS directly from Tracie and the other in-country staff who have supported the planning and implementation process in Trinidad and Tobago since 2012. During her week-long trip to Port of Spain, Quia observed the roles, responsibilities, and daily operations of Tracie, the Study Lead, the field supervisors, and other BBSS staff, and engaged in numerous staff and steering committee meetings.
I spoke with Quia and Tracie last week and asked them about this experience, and found that they both benefitted from the exchange in a number of ways. Quia explained that the trip strengthened her practical understanding of how BBSS may be implemented in The Bahamas, where the implementation process has not yet begun: “It was an interesting experience because I got to practically apply what it is that I have been learning theoretically. A lot of the reading that I have been doing, a lot of the research that I have been doing, the training that I have been receiving for this project; I have been actually able to see it from a practical standpoint, and able to see it applied. That in itself was an excellent opportunity.” At one point during the visit Quia participated in a ‘role play,’ where she played the role of a participant in the BBSS. Quia explained that she found this experience to be particularly informative because it “strengthened my understanding of the methodology of the entire study. It allowed for role reversal, so that while I am the Study Lead, if I am there at the site and a participant is there, I have walked through the process already so I know, okay, at this particular phase, this is what they may be thinking, this is how I need to approach this.”
While the trip certainly strengthened Quia’s understanding of the daily tasks and challenges involved in BBSS implementation, in Tracie’s view the trip was most meaningful because of the cross-Caribbean collaboration that it facilitated. As Tracie explained, “What often does not happen in the Caribbean, from my perspective, is that we don’t…seek to create synergy. And although Quia was here to learn from us, she was here and what happened was we began to create synergy. We gained an understanding of where we both were in terms of countries implementing a similar study.” What’s more, Tracie explained, the peer-to-peer approach strengthened the capacity of both Trinidad and Tobago and The Bahamas to become leaders in the Caribbean region in the development and implementation of HIV surveillance systems and studies: “Just as we were able to build on the experience of Seattle and to build on the experience in Baltimore (peer-to-peer TA provider to The Bahamas, via NASTAD), the Caribbean islands can now build on the experience of Trinidad and Tobago, build on the experience of The Bahamas... And this is taking us further along the track of having proficient, efficient, indigenous, culturally contextual surveillance systems that will benefit and help us all as a community.” If you are interested in learning more about what NASTAD is doing in the Caribbean to improve HIV surveillance and the use of surveillance data for program planning, monitoring, and evaluation, please contact Luisa Pessoa-Brandao.