Ferdinand Mkumbang

This session focused on integrating HIV prevention and care services for (1) people who inject drugs testing and treating for hepatitis, (2) trans people; and (3) people living with non-communicable diseases in sub-Saharan Africa. Service integration was proven to be successful in providing person-centered care and reducing HIV-related stigmas.

Same-day HCV test and treatment with linkages to HIV and HBV treatment and prevention: Integrating health services for people with Hepatitis B and C and HIV can help streamline the services for people who inject drugs. The success of this model was based on it being scaffolded by existing government structures, offering free HCV treatment. Hepatitis self-testing was preferred by the community, but the government is yet to tap into this potential. Integrated trans-competent care for trans women and trans men: There is a prevalence of 10-17% of HIV in the trans population in Thailand and stigma and discrimination remain a critical barrier to treatment and care. The ‘Tangerine’ is an integrated HIV care for trans offering them trans-centered integrated services which include hormone treatment and mental health services in addition to HIV treatment and care services. Improving outcomes through integrated HIV, diabetes, and hypertension care in sub-Saharan Africa: A one-stop clinic model is proposed as a better approach to vertical programs for the management of HIV, diabetes, and hypertension. One-stop clinics include the same physicians, consulting rooms, waiting areas, triage, provision of health information, similar records, pharmacy, and laboratory services, and are located within health facilities offering primary care.

Integrated service initiative seems to reduce HIV-related stigma as HIV is treated like any other chronic disease. Integration of services does not adversely affect HIV outcomes and they are likely to be highly cost-effective when compared with vertical care. Integrated care initiatives that leverage from existing health care services and partner with existing institutions are likely to provide high-quality, quick, and comprehensive care. In the case of the Tangerine model, people-centered care that is transgender-led and transgender-owned integrating gender-affirming care and trans-competent providers increase access to HIV and other sexual health services among transgender people.