The need for a wider implementation of differentiated, person-centered service delivery for HIV testing and treatment in Africa – World

Despite the remarkable progress made in the AIDS response in Africa, significant gaps and challenges remain to meet the 95–95–95 testing and treatment targets by 2025 and put the continent on the right track to achieve end the AIDS epidemic by 2030. UNAIDS, the World Health Organization (WHO) and partners met in a satellite session at the 2021 International Conference on AIDS and AIDS. IST in Africa to discuss how differentiated service delivery can bring the world closer to targets.

The provision of differentiated, person-centered services is essential to accelerate access and use of HIV testing and treatment services. As the COVID-19 pandemic has forced many countries to adapt HIV services to include delivery outside health facilities and by communities, and increasing the distribution of several months of HIV and other drugs, it also revealed a lack of resilience in key areas of health systems. , including the ability to ensure an uninterrupted supply of drugs and commodities, adequate funding for community-led organizations to provide service and support, and integrated service delivery for multiple health issues. These adaptations and gaps have underscored the feasibility and importance of providing differentiated, decentralized, integrated and community-based testing and treatment service models in different settings.

During the session, representatives from ministries of health and communities, program implementers, researchers and development partners highlighted ways in which differentiated service delivery has strengthened national efforts. to achieve their screening and treatment goals for all affected population groups. They also showcased new partnerships, tools, policies and best practices, and drew attention to important policy changes and innovations to expand the delivery of differentiated services, such as targeted community screening and self-testing. HIV, wider spacing of antiretroviral therapy distribution and clinical visits. , community distribution of antiretroviral therapy and peer support for linking and sustaining care for key and vulnerable populations.

“We are seeing huge differences in screening and uptake of treatment in different populations in different settings in Africa. For example, children lag behind adults, men lag behind women, and key populations living with HIV lag behind the general population of people living with HIV. HIV. It is essential to ensure differentiated, person-centered and community-centered service delivery approaches that address the barriers to access and the diverse needs of all affected populations, as well as conventional institutional service delivery, to avoid leave no one behind, ”said Ani Shakarishvili, UNAIDS Special Officer. Advisor, Access to Treatment, Care and Integration.

In April 2021, WHO released new guidelines on HIV prevention, testing, treatment, service delivery and monitoring. Updated service delivery recommendations include initiating antiretroviral therapy outside the health facility, spacing clinic visits, and distributing antiretroviral therapy every three to six months. The criteria for a person’s eligibility for differentiated service delivery for HIV treatment have also been updated.

“The changes that have been made allow more people to access differentiated HIV treatment services earlier to support their retention in care, meet their needs and preferences and move from one-size-fits-all to more person-centered approaches, “said Clarice Pinto, consultant on differentiated service delivery for HIV treatment at WHO.

Regarding the implementation and scale-up of differentiated models in countries, Anthony Ashinyo, Deputy Program Director for the National AIDS / STI Program in Ghana, stressed the need for multisectoral collaboration and partnerships between government, implementers and communities to increase uptake of differentiated service delivery. .

“I see us at the helm. I see us strengthening the influence of people living with HIV, care recipients and affected communities in the design and implementation of national strategies and plans, so that they reflect and respond appropriately to our realities. experiences and needs, ”said Elsie Ayeh, President of the Network of People Living with HIV / AIDS, Ghana.

The session ended with the launch of a call to action to leave no one behind by scaling up the provision of differentiated HIV testing and treatment services in Africa.

Learn more about the session and watch pre-recorded presentations on differentiated speaker service delivery here.


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