Peer-Delivered Linkage Case Management and Same-Day ART Initiation for Men and Young Persons with HIV Infection - Eswatini, 2015-2017

• Published in: MMWR. Morbidity and Mortality Weekly Report 2018, Vol.67 (23), p.663-667
• Main Authors: MacKellar, Duncan, Williams, Daniel, Bhembe, Bonsile, Dlamini, Makhosazana, Byrd, Johnita, Dube, Lenhle, Mazibuko, Sikhathele, Ao, Trong, Pathmanathan, Ishani, Auld, Andrew F, Faura, Pamela, Lukhele, Nomthandazo, Ryan, Caroline
• Format: Report
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adults; AIDS; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Case management; Communities; Disease control; Drug therapy; Enrollments; Epidemics; Historical account; HIV; Human immunodeficiency virus; Infections; Medical laboratories; Medical tests; Men; Nurses; Peers; Public health; Viruses; Young adults
• ISSN: 0149-2195; 1545-861X

To achieve epidemic control of human immunodeficiency virus (HIV) infection, sub-Saharan African countries are striving to diagnose 90% of HIV infections, initiate and retain 90% of HIV-diagnosed persons on antiretroviral therapy (ART), and achieve viral load suppression for 90% of ART recipients (90-90-90). In Eswatini (formerly Swaziland), the country with the world's highest estimated HIV prevalence (27.2%), achieving 90-90-90 depends upon improving access to early ART for men and young adults with HIV infection, two groups with low ART coverage. Although community-based strategies test many men and young adults with HIV infection in Eswatini, fewer than one third of all persons who test positive in community settings enroll in HIV care within 6 months of diagnosis after receiving standard referral services. As a demonstration project providing the package of linkage services that are recommended by CDC and WHO, CommLink achieved near universal early enrollment in HIV care and ART initiation among all participants during Test and Start, including men and young adults, two groups with historically low ART coverage.