With this call, Aidsfonds aims to financially support civil society organisations to develop, implement, and monitor an intervention to sustainably retain PLHIV in care. Of course, this should have a strong focus on those communities most vulnerable to drop-out incl. LGBT, children, women, drug users and sex workers.

When PLHIV drop out of the treatment cascade, the efforts put into testing and initiating treatment are lost. A focus needs to be put on supporting PLHIV to remain in care and grow old and healthy. In order to do so, we need to reduce barriers that complicate retention and support interventions that facilitate lifelong treatment.

An urgency to retain PLHIV in care 
Looking ahead, as HIV is becoming a chronic illness, two questions are: Are we equipped to retain all PLHIV in care in a sustainable way? How can we ensure people successfully live with a complicated infection for the rest of their lives? Retention in care is required for optimal clinical outcomes for PLHIV, keeping people alive, preventing medical toxicities, and identifying treatment failure in order to switch regimes. It also significantly reduces HIV incidence. Failure of treatment retention may result in drug-resistant mutations, limiting future drug options. We have all the tools needed for a person to grow old with HIV. With a growing 62% of PLHIV on treatment, now is the time to work on care retention.

Different across communities 
The 37 million PLHIV are not a homogenous group. People’s capacities and vulnerabilities differ greatly due to factors such as sex and age. Therefore, differentiated care is always preferred. We must ask ourselves: who is most at risk to drop out of care? How can we create community-specific measures to prevent this?  

Global targets 
The 90–90–90 UNAIDS targets are a collaborative framework to achieve the end of the AIDS epidemic by 2030. It is important to realise that the 90-90-90 treatment cascade is not one-directional nor linear; people can flow back and forth during different phases in their life. Therefore, the main goal is to have as many people with a suppressed viral load and to keep them at that level for as long as possible.

Universal Health Coverage
A sustained HIV response should be part of the Global UHC commitments. It is essential that efforts to achieve UHC include a fully funded AIDS response and strong community engagement. Moreover, we must build on the gains in human rights and gender equality made by PLHIV and key populations, as well as women and adolescent girls. 

Defining concepts 
Enhancing retention requires knowledge about the chain of events that leads to failure of retention. We must identify determinants of retention to target the right interventions to the right people. It is crucial to realise the magnitude of this in HIV programming, while also paying attention to the context-specific differences. Thus, know your epidemic locally, also from a client perspective.
 

Our work contributes to the following long-term goals: ‘less than 200,000 new HIV infections per year globally’ and ‘everyone living with HIV worldwide receives treatment’. At the heart of our work is supporting communities– so that they, themselves, can prevent new HIV infections and ensure all PLHIV have access to treatment.

We invite organisations that meet the definitions and criteria set by this call for proposals to apply for our Stay On grant that supports the proposed programmes for three years (2020-2022).

Objectives of Stay On

1. Expand successful approaches to ensure PLHIV grow old in good care. This means work at four levels:
   • PLHIV are supported to adhere to treatment throughout all phases of life
   • PLHIV have access to lifelong quality treatment
   • The healthcare system, which includes community-based approaches, is equipped to retain PLHIV in quality care
   • Structural barriers hampering PLHIV to remain in care are reduced
2. Reach long-term sustainability through national governments taking responsibility for systems to retain PLHIV in care throughout their lives. Have governments include treatment retention in their UHC package.

The deadline for submission of proposals is 12 September 2019 at 12:00 (noon) CEST.

How to apply

All applications must go through our online portal: https://aidsfonds.grantplatform.com  

• After creating an account you will receive an e-mail to activate the account (make sure to check you Spamfolder as well); click on ‘activate’ to start using your account.
• After logging in click on ‘Start application’ and select Chapter ‘Aidsfonds’, Category ‘Aidsfonds 2019 International – Stay On’
   

Timeline:

• 12 September 2019 - Deadline for submitting proposals by 12:00 (noon) CEST;
• End of October 2019 - Proposals reviewed by experts, anonymous review forms are sent to submitting organisation for rebuttal;
• Mid-November 2019 - Deadline for rebuttal by submitting organisation;
• Mid-December 2019 - Advice of the external advisory committee based on reviews and rebuttals to the board of Aidsfonds;
• Mid-January 2020 - Decision by the board of Aidsfonds, acknowledgements to applicants follow immediately after.

Documents

• Aidsfonds’ International Call for Proposals 2019
• Example application form
• Example result & budget framework
• Application regulations
• Other grants and funding information

We want all capable civil society and community-led organisations to have a chance at this grant. Please help us expand our reach by sharing this page with your network.