Title

What's new in DSD for HIV treatment: From WHO recommendations to reality

Code

SA18

Session Type

Satellite

Track

Not applicable

Channel

Channel 3

Date Time

18 July 21:00- 22:30

Local Date Time

21:00 - 22:30 W. Europe Daylight Time

Organizer:

The IAS – International AIDS Society – in collaboration with the World Health Organization

In April 2021, the World Health Organization released new clinical and service delivery recommendations for HIV prevention, treatment and care. The updated recommendations include actions that countries can take to improve the delivery of HIV treatment and care services, including integrated approaches to testing, by providing greater options for differentiated approaches. The aim of this satellite is to inform ministries of health, HIV programme managers, members of civil society and other stakeholders about key changes to the guidelines and share data from early adopters of these policies along with experiences on how to operationalize implementation of the new guidelines. These recommendations include earlier eligibility for differentiated service delivery (DSD) for HIV treatment after six months on antiretroviral therapy (ART); updated recommendations for pregnant and breastfeeding women on ART; frequency and alignment of clinical visits and ART refills, as well as new aspects for integrating HIV treatment with family planning and the management of non-communicable diseases.

15 min	What’s new in DSD for HIV treatment: from WHO recommendations to reality Nathan FORD, Switzerland Anna GRIMSRUD, International AIDS Society, South Africa

2 min	As someone who was part of the guidelines committee – what are you most excited about? (Perspective video) Aleny COUTO, MINISTRY OF HEALTH, Mozambique

2 min	What is your reaction to these updated guidelines? (Perspective video 1) Erika CASTELLANOS, Global Action for Trans Equality (GATE), Netherlands

2 min	As someone who was part of the guidelines committee – what are you most excited about? (Perspective video 2) Baker BAKASHABA, The AIDS Support Organization (TASO), Uganda

10 min	Community ART initiation: implementation experience from Lesotho Thabo Ishmael LEJONE, Lesotho

2 min	What is your reaction to these updated guidelines? (Perspective video 2) Stephen AYISI ADDO, GHANA HEALTH SERVICE, Ghana

2 min	What is exciting to you about the new service delivery guidelines? (Perspective video 1) Inad Quiñones RENDON, APCOM, Thailand

10 min	Annual clinic visits and extended ART refills in different DSD for HIV treatment models: implementation research experience from Lesotho and Zimbabwe Geoffrey FATTI, South Africa

2 min	What is exciting to you about the new service delivery guidelines? (Perspective video 2) Catherine NGUGI, National AIDS abd STIs Control Porgramme, Kenya

2 min	What is exciting to you about the new service delivery guidelines? (Perspective video 3) Nomthandazo LUKHELE, World Health Organization, Eswatini

10 min	Interventions to support re-engagement to care: best practices from PEPFAR partners Godfrey CATHERINE, Department of State, United States

2 min	What will you prioritize from these new guidelines? (Perspective video) Cindy AMAIZA, Organisation of Young People Living with HIV(Y+Kenya), Kenya

2 min	What will you prioritize from these new guidelines? (Perspective video 2) Oucul LAZARUS, The AIDS Support Organization (TASO), Uganda

10 min	Integrating hypertension care in DSD for HIV treatment: implementation experience from Uganda Martin MUDDU, Aids Health Organization-Uganda Carea, Uganda

3 min	What’s your hope for DSD for HIV treatment over the next 5 years? (Perspective video) Peter EHRENKRANZ, Bill & Melinda Gates Foundation (BMGF), United States

3 min	What’s your hope for DSD for HIV treatment over the next 5 years? (Perspective video 2) Meg DOHERTY, World Health Organization, Switzerland

11 min	Wrap up Anna GRIMSRUD, International AIDS Society, South Africa Nathan FORD, Switzerland

AUTHOR

Elving Geng

SUMMARY

This session discussed new recommendations from 2021 consolidated guidelines for service delivery from the WHO. After highlighting new recommendations regarding community-based treatment initiation, re-engagement, psychosocial support for adolescents, the session heard from a range of voices exploring practical implications, barriers and facilitators to successful adoption.

HIGHLIGHTS

In this densely packed session, Nathan Ford (WHO) and Anna Grimsrud (IAS) led a exciting conversation in which a range of stakeholders commented on the new 2021 Service Delivery Guidelines from WHO. New recommendations in the 2021 document were (1) offering community-based ART initiation, (2) tracing and re-engagement for lost patients, (3) psychosocial support for all adolescents and (4) integration of hypertension and diabetes care. The rich diversity of perspectives included, but was not limited to the following: Bakar Bakashaba from the AIDS Support Organization in Uganda noted the potential of community-based ART initiation to increase reach of services. Kate Godfrey from the Office of the Global AIDS Coordinator shared data from a Nigeria using analytics to identify losses, and re-engaging those who have lapsed. Martin Muddu from Uganda described recent work in Kampala bringing hypertension care into HIV services, a process now being used by the Ministry of Health in to inform wider scale-up. Cindy Amaiza from the Organization of Young People Living with HIV(Y+Kenya) Kenya emphasized the impact of support for managing disclosure and medication adherence. Erika Castellanos of the Global Action for Trans Equality (GATE) based in the Netherlands celebrated the involvement of PLHIV in guideline process.

CRITICAL ASSESSMENT

Overall, progress toward person-centered HIV service delivery through more nuanced, more flexible and "lighter touch" delivery models, is reflected both the the direction of WHO guidelines for service delivery. Both implementers as well as communities of persons living with HIV welcome these innovations. An IAS dashboard, however, tracking adoption of differentiated service models, however, shows significant heterogeneity across countries. Work to understand barriers to uptake as well as ensure that guidelines are supported by a community of practice able to champion policy adoption and practice implementation is need to advance person centered health services.