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Lesotho HIV sites see ART start-up increases around 80%

Issue: October 2017

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A universal treatment program has increased by 79% the average monthly number of people initiating HIV therapy at a group of relief sites in Lesotho, according to a CDC epidemiologist.

The increase was seen in preliminary results of the program known as Test and Start, which is aimed at eventually diagnosing HIV and providing ART to all people who need it. Test and Start was provided at the 120 Lesotho treatment sites supported by the President’s Emergency Plan for AIDS Relief (PEPFAR), Amee M. Schwitters, PhD, of the CDC’s Center for Global Health, Division of Global HIV and TB, wrote in an MMWR. She added that officials plan to expand PEPFAR support to 32 more sites in fiscal year 2018.

“The partnership between the Lesotho Ministry of Health, PEPFAR and implementing partners has resulted in promising preliminary results after implementation of Test and Start,” she wrote. “Sustained progress will represent a critical step toward achieving epidemic control.”

In the 8 months before Test and Start began at the PEPFAR sites — October 2015 to May 2016 — 14,948 patients initiated ART there. In the 9 months since the program began — June 2016 to February 2017 — 30,146 started ART.

The average increases per month in ART coverage varied by age group. The increase was 72% for patients younger than age 15 years, 84% for those aged 15 to 24 years and 79% for those aged 25 years and older.

The average monthly increases also varied by district and ranged from 62% in Mohale’s Hoek to 109% in Leribe, Schwitters said.

She added that Test and Start expansion throughout Lesotho can do much to fight the HIV epidemic in a country in which nearly 25% of people aged 15 to 49 years have the virus.

“Successful implementation of Test and Start in all sites and districts across Lesotho, coupled with additional measures to retain HIV-positive persons newly initiated on treatment, could help maximize the success of Test and Start and the benefit of treatment to prevent new HIV cases,” Schwitters wrote. – by Joe Green

Reference:

Schwitters AM. MMWR Morb Mortal Wkly Rep. 2017;doi:10.15585/mmwr.mm6630a4.