IAS 2017 IASconference Conflict of Interest No conflicts

#IAS 2017 | @IAS_conference Conflict of Interest “No conflicts of interest to declare”.

Implementing Test & Start program in a rural conflict affected area of South Sudan @ Teresa Sánchez Ravina Cecilia Ferreyra 1, Victoria Achut 2, Richard Loku Lino 2, Brenda Oulo 1, Elena Grandio 1 1 Médecins San Frontierès, 2 Ministry of Health, Republic of South Sudan, HIV/AIDS/STI, Juba, South Sudan,

#IAS 2017 | @IAS_conference § HIV adult prevalence: 2. 7% (6. 8% in Western Equatoria) § Hospital-based HIV counselling and testing (HCT) and antiretroviral therapy (ART) § ART coverage < 20% § Conflict affected area since OBJECTIVES 2015 § Bring HCT and ART closer to the communities § Increase ART coverage and reduce loss to follow up § Implement early ART initiation § Assess feasibility and acceptability

#IAS 2017 | @IAS_conference METHODS Health Promotion by CHWs Contingency plan Decentralized mobile teams: HCT, ART initiation, drugs refill and clinical follow up

Health Education and Mobilization HIV counselling and testing @ Teresa Sánchez Ravina Mobile Clinics ART initiation Follow up and refill

Contingency Plan

#IAS 2017 | @IAS_conference RESULTS Retention in care at 6 months: 291 (84%) Retention in care at 12 m: 277(81%) Tested 13, 872 people HIV positive 442 (3. 2%) ART initiation 344 (77%) CD 4 < 500 cells/mm 3 207 (60%) 500 HIV CASCADE Cases 400 77% 78% 300 200 38 100 442 344 269 130 86% 114 0 HIV diagnosed ART initiation Retention in Care Available viral Suppresed viral load

#IAS 2017 | @IAS_conference CONCLUSIONS HCT and early ART initiation is feasible and highly accepted in this setting Retention in care and viral suppression are comparable to HIV programs primary at care level non-conflict in settings Contingency plans, including run-away bags are essential This strategy could be replicated in other contexts with low access to ART and instability @Anna Kerber

#IAS 2017 | @IAS_conference Thanks to Yambio field team @ Teresa Sanchez Rovina