Abstract no TUPDE 0106 INCREASING LINKAGE TO HIV

Abstract no. TUPDE 0106 INCREASING LINKAGE TO HIV CARE FOR NEWLY DIAGNOSED HIV INFECTED PERSONS THROUGH QUALITY IMPROVEMENT APPROACH IN URBAN SLUMS IN KENYA Author: Kegoli S 1, Njoroge A 1, Motoko J, Muriithi C, Mutisya I 2 Affiliations: 1 Eastern Deanery AIDS Relief Program, Nairobi, Kenya ; 2 Division of Global HIV/AIDS, U. S Centers for Disease Control and Prevention, Nairobi, Kenya #AIDS 2016 | @AIDS_conference

Increasing linkage to HIV care for newly diagnosed HIV infected persons through Quality Improvement approach in urban slums in Kenya Introduction : • Effective linkage from HIV testing to HIV care ensures that persons living with HIV/AIDS receive the services they need to improve their health and enhance their quality of life. • Despite Scale-up of HIV testing coverage only 60% of HIV-positive clients were tested were linked to care and treatment in Kenya. • Eastern deanery aids relief program (EDARP) utilizing the Kenya HIV Quality Improvement Framework (KHQIF) to improve linkages care /treatment in its 14 facilities in Nairobi. • Gaps were identified in HIV linkages to care with an aim to improving linkages from 60% to above 90% • Routine clinical data was between October 2011 and September 2015 #AIDS 2016 | @AIDS_conference

CQI strategies Patient escort : Patient who test HIV positive from VCT are escorted to the clinician after testing to ensure successful linkages. Linkage register : Linkage registers were developed after noting those clients not linked on the same date are hard to track. . Trainings/linkage register/ QI teams (multiple strategies) : Teams were taken through the following strategies to improve linkages. Results • PDSA cycle 1 (patient escort) - Patient escorts by counselors which led to increased linkage from 60% to 80. 8% by June-2012 • PDSA cycle 2 (linkage register + patient escort) - Introduced linkage registers for counselors to track intra-facility linkages This was in addition to patient escorts, telephone calls and home visits for patients not linked on the testing day. Linkages improved linkages from 74. 2% to 91. 8% by Mar-2013. • PDSA cycle 3 (linkage register, patient escort, Trainings, peer-peer support&trainings) linkages had improved and were sustained at 98% by Sept-2015. #AIDS 2016 | @AIDS_conference

Results/Lessons learned Table: Trends of improved linkages to care of newly diagnosed HIV infected persons between Oct-2012 and Sept-2015 #AIDS 2016 | @AIDS_conference

Conclusion Successful Linkages to HIV care and treatment services may be achieved through adoption of multiple strategies that are feasible and affordable #AIDS 2016 | @AIDS_conference