1. 1 NAME: TITLE:DATE:

2. 2 “One stop shop” for TB and HIV services improved initiation of antiretroviral therapy (ART) for co-infected patients in Eastern Uganda 21st International AIDS Conference Durban, South Africa 21 st July 2016 Andrew Mukuye

3. 3 Background One of 22 TB high burden countries and 41 TB/HIV high burden countries globally Generalized HIV epidemic: 7.3% among ages 15-49 High TB/HIV co-infection rate: 45% (2015 Global Tuberculosis Report) Initiation of antiretroviral therapy (ART) for patients co-infected with HIV and TB is low in certain districts of Eastern Uganda Co-locating TB and HIV services is one strategy to increase uptake among co-infected patients Uganda

4. 4 Strengthening TB and HIV & AIDS Responses in Eastern Uganda (STAR-E), a USAID project funded by PEPFAR and implemented by Management Sciences for Health, supported a health facility-based intervention in TB treatment sites in Kapchorwa District. Before the implementation of the one stop shop model, TB and HIV services used to be offered in separate clinics and by separate clinical teams. Intervention: On-site mentorship to implement a “one-stop shop” model for treating TB/HIV co-infected patients: –training on the Uganda national guidelines for treating TB/HIV co-infection –provision of job aids, guidelines, and diagnostic charts –peer mentorship Methodology

5. 5 Cohort: 15 health workers (TB clinic, ART clinic, and mother-baby care point) at 5 health facilities Timeline: January-September 2015 Data collection: baseline (Oct- Dec 2014) and quarterly from unit TB registers using the MOH standard HMIS tool (HMIS 106 a)

6. 6 One-stop –shop model for TB/HIV services

7. 7 Results Quarter Total cases detected Tested for HIV % who testedHIV+% HIV+CPT% on CPTARV % on ART Oct-Dec 2014302893%1967.90%19100%842% Jan-Mar 201532 100%1650.00%16100%1488% Apr-Jun 201523 100%1565.20%15100%1387% Jul-Sep 201529 100%1344.80%13100%13100%

8. 8 Results

9. 9 Conclusions and Recommendations Vertical HIV/AIDS and TB programs that treat each disease separately are inadequate and should be replaced by new models of care that integrate services and maximize efficient use of already-limited resources. This intervention indicates that integration may be effective for timely initiation of ART amongst TB/HIV patients in a low resource rural African setting. Scale up of this approach to health facilities providing TB/HIV services should be considered. Ongoing mentorship is critical to the success of this “one stop shop” model.

10. 10 www.msh.org