Background: Despite linkage between HIV/STI and gender based violence (GBV), services for GBV survivors are limited. In 2016, the PEPFAR funded project in Lubombo region started developing regional capacity for provision of medical and therapeutic counselling care to survivors GBV. The objective is to share lessons learned from establishing a GBV screening program in Lubombo for HIV care and treatment programs.
Description: Between September 2016 and September 2017, GBV services were established in 9 health facilities in Lubombo, and later expanded to 29 health facilities. A reporting network established for social, health, legal, police and community linkages and tools were developed. GBV Peer navigators routinely screened for GBV, provided health education, medical, therapeutic counselling and referral services. Data were de-identified and analysis done for routine patient care, quality improvement and program purposes.
Lessons learned: (1) the burden of HIV among GBV cases was high,
(2) as GBV screening program identifies links HIV positive cases to HIV care and treatment,
(3) referral network for GBV screening, and services increases GBV reporting, and
(4) GBV survivor''s empowerment is critical for post GBV HIV prevention services. From inception, GBV case reporting increased from 1 GBV case per health facility per month to 12 cases. A total of 584 cases with mean age of 25 years were reported: 478 (75%) females; < 10 years (63), 10-14 (24), 15-24 (79), 20-24 (91), and 25+ (321). Emotional and psychological constituted (42%) neglect and economic abuse (29%), physical abuse (19%) and sexual abuse (10%). 100% of cases received psychosocial package. 67% Sexual abuse cases who reported within 72 hours were eligible and received post HIV/ FP post exposure prophylaxis (PEP). 66 GBV cases came with HIV known status, 139 tested on site were HIV positive. All HIV positive cases were linked to treatment and care. 70% of GBV cases reported to health care facility/peer navigator and 30% to police then referred to health facility.
Conclusions/Next steps: National scale of GBV screening in health facilities, the network for GBV referrals and empowerment of GBV survivors should strengthened as an entry into care and for HIV prevention services.

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