Ayden Scheim

Four presentations focused on efforts to accelerate progress along the HIV testing and care continuum through rapid or same-day ART initiation in eSwatini, Uganda, Bangkok, and Botswana. Exciting data were shared from Namibia, indicating that it has exceeded UNAIDS 2020 targets for viral suppression.

The CommLink program in eSwatini (including community-based testing, mobile care, and peer-based linkage) achieved 96% ART initiation, and 73% rapid initiation. In a Ugandan community-based testing and ART delivery intervention, 80% of HIV-positive persons identified were eligible for same-day ART start (53% male). At a Bangkok sexual health clinic, 79% of diagnosed patients received same-day ART and were 2.2 times as likely to be virally supressed (vs. standard of care). Implementing fast-track ART initiation in Botswana improved median time from linkage to first viral suppression from 210 to 104 days. Among Kenyan adolescents living with HIV, high self-reported adherence was associated with good engagement in care among their caregivers. Bernard Haufiku, Namibia’s Minister of Health and Social Services shared that an estimated 77% of PLHIV in the country are virally suppressed (irrespective of knowledge of HIV status) and that women achieved all 90-90-90 targets.

Rapid and same-day initiation of ART is achievable in low-resource settings, particularly when linkage and ART delivery occur in accessible community settings, however there is a need to monitor and understand retention in care. Involvement of KP peers and staff in linkage to care and retention is key to success. Namibia has reached and exceed UNAIDS 2020 targets for viral suppression, however, viral suppression among young men remains suboptimal.