Siempre Unidos (SU) exists to contain the HIV/AIDS epidemic in Honduras and minimize its impact on the community. Working in cooperation with the Honduras Secretary of Health and the Episcopal Diocese of Honduras, SU is the only non-governmental organization (NGO) authorized to provide HIV care in Honduras. Our clinics have served as models to the government-run clinics introducing second- and third-line antiretroviral medications for patients with resistant disease, treating HIV-negative clients in the same facilities to minimize stigma, adding psychologists, social workers and home visitors to maximize compliance, and providing HIV screening throughout the community. These activities are emulated by the Ministry of Health to improve care throughout the country. SU has a comprehensive laboratory including a Viral Load machine (the second in the country and often the only one functioning) and a CD4 machine to facilitate prompt treatment changes when medically indicated.

SU's vision is that every HIV-positive person in Honduras has high-quality care and can live free from stigma. SU advocates for high-risk groups including the LGBTQI community, commercial sex workers, and women and girls in general. (Honduras has one of the highest femicide rates in the world). SU actively leads solidarity marches and provides legal support for victims of hate crimes. SU has worked nightly for over 18 years with commercial sex workers to provide HIV screening, education about safe sex, and a security network. In the process, the rate of HIV infection among commercial sex workers in San Pedro Sula has dramatically decreased. SU provides workshops for impoverished women and girls to learn skills and improve self-esteem. Thirty seven percent of SU HIV-positive clients identify as LGBTQI, higher than in other government HIV clinics.

Source: Nonprofit submitted responses

Goal One: Our first strategic goal is to maintain high-quality and compassionate HIV clinical, outreach, and advocacy services. SU does not discriminate based on gender, sexual orientation, or ability to pay.

Goal Type: Focus on core programs to achieve mission and scale back on programs not seen as core.

Goal Two: Our second goal is to meet the changing needs of our patients by developing new treatment protocols and programs for people aging with HIV and at risk of poor health outcomes.

Goal Type: New program(s) based on observed changes in needs among our constituencies/communities served.

Goal Three: Our third goal is to meet the challenges of a changing climate seeing more hurricanes, flooding, and heat. We installed major drainage canals and pipes and will eventually adopt solar power.

Goal Type: Invest in the capacity of our organization (financial, management, technical, etc.).

Describe an investment in leadership

An investment in leadership development is to annually send one of our physicians to the HIV & Hepatitis in the Americas conference held in a Latin American country. This provides the opportunity to learn from leading practitioners and researchers and to share best practices. A second example is to hold in-service trainings for staff to learn new treatment protocols and to brainstorm new services to meet our patients' needs. SU Honduran physicians also seek medical advice from US HIV specialists regarding complex patient care issues. Finally, SU has sponsored the annual travel of the Honduran director and a second staff person to the U.S. This provides employees the opportunity to learn about the U.S., meet the U.S. board and donors, and gain public speaking and presentation skills.

This organization mobilizes for mission in the following ways:

• Strategic Partnerships

• Community Building

• Policy Advocacy

What are this organization’s external mobilizaton efforts?

Strategic Partnerships - SU mobilizes for its mission by partnering with Honduran governmental and community-based organizations. SU is a part of the Secretary of Health's (SOH) network of 53 HIV treatment facilities. As such, it participates in monthly meeting with the SOH and World Health Organization to discuss best practices and treatment regimens and identify barriers to services. SU collaborates with faith- and community-based organizations including the Mennonite Social Services, Lutheran Social Services, and a government-run clinic providing women's health services. Together, we have improved HIV testing and treatment for internally displaced migrants and mobilized delivery of urgently needed food and supplies after hurricanes Eta and Iota. Community Building & Advocacy - We partner with advocacy organizations supporting the rights of the LGBT, transgender, and commercial sex worker communities for protection from discrimination and for reporting of human rights abuses.

Since its founding as a 501(c)(3) organization in 2004, Siempre Unidos (SU) has been guided by its Honduran Director, Pascual Torres, JD, and U.S. Board President, Denise Main, MD. They have had to ensure program integrity and lead the SU staff, board, and stakeholders through a coups d' etat, natural disasters, and gang and extrajudicial violence. Over the past year, SU faced several external changes. The greatest were the COVID pandemic and destruction to the homes and livelihoods of our patients and communities by hurricanes Eta and Iota. When the COVID pandemic started, there were several external factors impacting our services. First, Honduras' authorities imposed strict curfews limiting travel outside of the home to once every ten days. To adapt, SU scheduled appointments to accommodate the restrictions as well as visited patients in their homes. Second, SU rapidly prepared for the impact of COVID-19 and purchased sufficient personal protective equipment (PPE). Through our partnership with a US charity, Direct Relief, and fundraising, we were additionally able to procure donated PPE to protect patients and staff. Third, SU's normal clinical flow did not allow for sufficient social distancing. The staff revised appointment procedures and increased home visits to ensure that the clinics maintained a steady but lower flow of patients. In November 2020, hurricanes Eta and Iota caused severe flooding. Mud filled houses and businesses, livestock drowned. Homes and livelihoods were literally swept away. SU serves impoverished communities that do not have a safety net. SU's board, staff, and donors organized to respond. The Board successfully raised $120,000 in one month to provide over 180 patients and their households with food, cookstoves, beds, and reconstruction supplies. The staff identified the most impacted and vulnerable patients for hurricane relief as well as partnered with community organizations to find other families who needed help.