Beryne Odeny

Discussions focused on strategies to support adolescents’ engagement in HIV treatment; promoting choice in selection of PrEP methods among adolescent girls and young women; and high-level discussions on national strategies for implementation and scale up of HIV Self Testing (HIVST) and HIV/syphilis dual testing using rapid diagnostic tests (RDTs).

Florence Mwangwa presents findings from “SEARCH-Youth, a cluster randomized trial of a multilevel health system intervention” which consisted of interactive sessions on life changes/ barriers that affect adherence and rapid feedback of viral load results. The intervention resulted in significant increase in virologic suppression, especially among adolescents and young adults re-engaging in HIV care. Asha Hedge describes the STAR program in India and Indonesia, the associated progress and failures in implementation, scale-up, and sustainability of HIV self-testing in India and Indonesia. There is urgent need to work with regulatory authorities to support registration of HIVST products at country-level. Governance is needed to support operationalization of HIVST. Nagesh Borse discusses a discrete choice experiment on preferred PrEP methods among adolescent girls and young women in Namibia. Oral PrEP knowledge and awareness was high. 83% were willing to use any PrEP. 61% preferred long-acting cabotegravir due to its frequency, and discreteness. Andrew storey explores the role of dual HIV/syphilis dual rapid diagnostic tests (RDTs) in elimination of mother-to-child-transmission in Nigeria. Dismally, 15% of women who tested for HIV in ANC access syphilis screening. Uptake and acceptability of dual RDTs was high. Countries have adopted the test but there are huge implementation gaps.

Interactive sessions and rapid results feedback improve adolescents’ health outcomes. Understanding what drove youth preference for in-facility service is needed. When scaling up HIVST, it is important to account for linkage to treatment and prevention services, with special consideration to missing risk groups. Among girls and young women, PrEP preference was primarily driven by risk profile – does age also drive preference? Dual RDT testing can be transferrable to other settings and diseases such as hepatitis. Nigeria scale-up provides a broad roadmap that can be applied to different contexts. In-country adoption (e.g., guideline change) does not necessarily translate to implementation.