As countries progress towards meeting UNAIDS 95-95-95 targets for HIV diagnosis, treatment and viral suppression, PEPFAR service implementers are approaching the “last mile” of identifying missing cases and new infections in the most hard-to-reach populations.
MHRP’s PEPFAR implementing partners in Kenya’s South Rift Valley (SRV) led the country in identifying individuals living with HIV and getting them on treatment, according to 2023 4th quarter performance data.
The program provides HIV testing services in Kericho, Bomet, Nandi and Narok counties. In 2023, MHRP’s partners tested 286,551 individuals in the region and identified 5,634 cases of HIV, exceeding PEPFAR performance goals.
“It’s so critical that we find and test those who do not yet know their status and put those who test positive on treatment,” said Kim Bohince, MHRP’s Director of Global Health. “Finding these remaining individuals is challenging and requires a creative and tailored case identification approach.”
There are difficulties saturating the South Rift Valley region with testing services because of its expansive rural landscape. The program has worked to improve performance by closely tracking testing data and providing site-level mentorship for those facing challenges. The program focused on case identification to target testing services based on several criteria, including risk behaviors and patient symptoms.
Community outreach was critical to increasing access to testing services. “We reviewed geographical and subpopulation coverage gaps to identify opportunities that helped us reach the unreached by mapping out potential hotspots,” said Dr. John Owuoth, the HJFMRI Kenya PEPFAR Country Director. For example, in Narok the case finding team targeted higher learning institutions, the gold mines, and charcoal burning and sand harvesting areas for increased engagement. A social network strategy was implemented to speak to hard-to-reach populations and young people.
Testing and outreach staff played a key role in the program’s success, including Dr. Isaac Tsikhutsu, Acting SRV PEPFAR Program Director; Fillet Lugalia, the SRV Program Manager for Case Finding; and Jane Muli, SRV PMTCT Program Manager and County Liaison.
“Achieving these targets was a significant milestone for the program that demonstrates the effectiveness of innovative strategies,” said Owuoth. “The program will continue to scale up the strategies to narrow the gap on treatment coverage.”