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Presentation transcript:

“No conflicts of interest to declare”. Conflict of Interest “No conflicts of interest to declare”.

Implementing Test & Start program in a rural conflict affected area of South Sudan @ Teresa Sánchez Ravina Cecilia Ferreyra1, Victoria Achut2, Richard Loku Lino2, Brenda Oulo1, Elena Grandio1 1Médecins San Frontierès, 2Ministry of Health, Republic of South Sudan, HIV/AIDS/STI, Juba, South Sudan,

HIV adult prevalence: 2.7% (6.8% in Western Equatoria) Hospital-based HIV counselling and testing (HCT) and antiretroviral therapy (ART) ART coverage < 20% Conflict affected area since 2015 OBJECTIVES Bring HCT and ART closer to the communities Increase ART coverage and reduce loss to follow up Implement early ART initiation Assess feasibility and acceptability

Health Promotion by CHWs METHODS Decentralized mobile teams: HCT, ART initiation, drugs refill and clinical follow up Contingency plan Health Promotion by CHWs

HIV counselling and testing Mobile Clinics Health Education and Mobilization HIV counselling and testing ART initiation @ Teresa Sánchez Ravina Follow up and refill

Contingency Plan

RESULTS Retention in care at 6 months: 291 (84%) Tested 13,872 people HIV positive 442 (3.2%) ART initiation 344 (77%) CD4 < 500 cells/mm3 207 (60%)

CONCLUSIONS HCT and early ART initiation is feasible and highly accepted in this setting Retention in care and viral suppression are comparable to HIV programs at primary care level in non-conflict settings Contingency plans, including run-away bags are essential This strategy could be replicated in other contexts with low access to ART and instability @Anna Kerber

Thanks to Yambio field team @ Teresa Sanchez Rovina