February 2018—Fifty-two-year-old Milton Stewart beams with joy as he takes his place behind the steering wheel. As one of the official drivers for the Ministry of Health within the western division of Jamaica, Stewart has operated many vehicles during his 30-year career, including trucks, buses and ambulances. Few assignments, however, are as meaningful to him as the job he now has.

For the last five years, Stewart has driven the ministry’s HIV testing and treatment bus, a vehicle specially designed to bring services and outreach activities to key populations at risk of infection. Traveling on the bus, behavior change officers bring HIV testing and counseling services to thousands of clients across western Jamaica, an area that spans approximately 1,300 miles. They also help to educate and raise public awareness about the virus.

An estimated 30,000 Jamaicans live with HIV, which means the country bears the largest disease burden among island nations in this subregion of the Caribbean. The Jamaican Ministry of Health’s national response, with support from USAID since 2008, aims to reduce the sexual transmission of HIV by targeting key populations at the highest risk of infection, including sex workers, men who have sex with men, and transgender people. The initiative offers prevention information, HIV testing, and free antiretroviral treatment at respective clinics for all persons diagnosed with HIV.

At first, the testing and treatment bus project had some challenges. Clients were reluctant to visit an older version of the bus because of its open interior, which left clients feeling exposed to onlookers and other visitors. This limited the number of people willing to get tested.

To address these concerns, in 2016, USAID provided the Ministry of Health with a bus that was specifically designed for HIV testing. The bus features tinted windows and includes four testing stations with partitions for privacy. Since the introduction of the new bus and other innovative public outreach approaches, there has been a 150 percent increase in testing among key populations.

Stewart is extremely happy with the results. “One of my greatest joys of driving is when we go out as a team, and we find a vast number of clients who get tested during the day and night,” Stewart said, smiling. “I ask the officers, ‘How many did we do today?’ And when we hit our big targets, that’s what gives me joy.”

Through funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the United States joined the Government of Jamaica’s efforts to combat HIV in 2008. Within Jamaica, USAID provides assistance through the Jamaican Government and community-based organizations that are implementing HIV prevention programs. These activities target key populations at risk for HIV infection and address stigma, gender norms, and gender-based and sexual violence. With PEPFAR funding, USAID supported the delivery of HIV counseling and testing to nearly 200,000 clients by 2015. Following a shift to focus on key populations, more than 4,100 sex workers and men who have sex with men were tested between 2016 and 2017.

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