USAID STRENGTHENING THE CARE CONTINUUM PROJECT (The Care Continuum) Using HIV+ MSM case managers as a strategy to achieve the 2nd and 3rd 90 of the UNAIDS 90-90- 90 HIV treatment targets among MSM 10 May, 2018

Authors: Affiliation: G. Ekem-Ferguson1, M.K. A. Owusu1, S. Wosornu1, G.P. Awuzu1 J. Agyekum2 S. Benefour4, E. Adiibokah4, M. Molly3, Y. Abdul Rahman3, H.Nagai3 1Maritime Life Precious Foundation 2Effia-Nkwanta Regional Hospital; Takoradi, 3JSI Research & Training Institute, Inc. Authors: Affiliation:

Outline Issue Description Lessons Learned Next steps

Issue Enrolment in care and initiation on ART of HIV-positive MSM is low. High rates of denial of HIV infection, fear of stigmatization, and myths around the side effects of antiretroviral drugs (ARVs) drastically affect the treatment initiation rate of HIV-positive MSM and in some cases, result in lost to follow-up and defaulting from treatment. Case managers can play an effective role in successfully increasing the rate of treatment initiation of HIV-positive MSM.

Description Maritime Life Precious Foundation (MLPF), under the USAID Strengthening the Care Continuum project, implemented by JSI Research and Training Institute Inc., trained 2 HIV-positive MSM case managers to help bridge the gap between HIV diagnosis to ART enrolment in Shama district and Sekondi Takoradi Metropolis (STMA). The case managers offered services ranging from supporting their clients to complete all the required laboratory tests, ART literacy including adherence, positive living, and disclosure to their partners.

Description continued They were integrated in the health facilities to support the work of nurses, trace positive cases to care and follow up with services to ensure that they do not default or get lost to follow-up.

Lesson learned The case managers introduced from July 2017 to January 2018 were successful in facilitating the initiation and retention of HIV-positive MSM on ART.

Lessons learned Increased ART initiation and retention rate recorded with the introduction of case managers

Lessons learned contd. Additionally, 15 MSM PLHIV have been virally suppressed with viral load < 1000 copies/ml after 6 months of treatment. Case manger (right) providing education on viral load testing to a KP PLHIV

Lessons learned contd. Viral suppression Friendly client centered service These findings give an indication that case managers play a vital role in enhancing services for HIV-positive MSM and increasing ART initiation and retention rates. Case management Increased ART initiation rate Reduction in defaulters Increased retention rates

Next Steps Case management is a vital strategy to increase initiation on ART and reduction in defaulters or lost to follow up among MSM PLHIV. Additional case managers should be trained to improve efficiency considering the number of positive patients to be manage. Case managers should be integrated into the health service delivery in the country as they occupy a very important place in the area of providing health service to KPs as the evidence suggest

Thank you