Country Posters—Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale

This set of posters from Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale—a PEPFAR-supported meeting convened in 2016 to advance the scale-up of viral load (VL) services in sub-Saharan Africa—describe country experiences implementing routine VL monitoring. Posters from Kenya, Lesotho, Malawi, Mozambique, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe are included.

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Reaching the Third 90: Implementing Routine Viral Load Monitoring in Kenya

This poster, from Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale—a PEPFAR-supported meeting convened in 2016 to advance the scale-up of viral load (VL) services in sub-Saharan Africa—describes Kenya's experience implementing routine viral load monitoring. It summarizes VL guidelines and laboratory systems, the VL monitoring process and capacity of health care workers to scale up VL monitoring, M&E systems for VL monitoring, and lessons learned in Kenya.

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Reaching the Third 90: Implementing Routine Viral Load Monitoring in Lesotho

This poster, from Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale—a PEPFAR-supported meeting convened in 2016 to advance the scale-up of viral load (VL) services in sub-Saharan Africa—describes Lesotho's experience implementing routine viral load (VL) monitoring. It summarizes the laboratory system and the clinical/program systems for VL monitoring, engagement of patients and communities, M&E systems for VL monitoring, and next steps/way forward in Lesotho.

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Reaching the Third 90: Implementing Routine Viral Load Monitoring in Malawi

This poster, from Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale—a PEPFAR-supported meeting convened in 2016 to advance the scale-up of viral load (VL) services in sub-Saharan Africa—describes Malawi's experience implementing routine viral load (VL) monitoring. It summarizes the laboratory system and the clinical/program systems for VL monitoring, engagement of patients and communities, M&E systems for VL monitoring, and next steps/way forward in Malawi.

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Reaching the Third 90: Implementing Routine Viral Load Monitoring in Mozambique

This poster, from Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale—a PEPFAR-supported meeting convened in 2016 to advance the scale-up of viral load (VL) services in sub-Saharan Africa—describes Mozambique's experience implementing routine VL monitoring. It summarizes the national laboratory systems for VL monitoring, as well as clinical and program systems and M&E systems. Key next steps and way forward towards the goal of epidemic control in Mozambique are highlighted.

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Reaching the Third 90: Dried Blood Spot Specimens for HIV-1 Viral Load Determination Using COBAS® AmpliPrep/ COBAS® TaqMan® HIV-1 Test, v2.0 in Swaziland

This poster, from Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale—a PEPFAR-supported meeting convened in 2016 to advance the scale-up of viral load (VL) services in sub-Saharan Africa—describes a study conducted in Swaziland to verify if VL test results using dried blood spots (DBS) prepared from venous blood (V-DBS) and VL results from finger prick DBS (FP-DBS) can produce comparable results to plasma. The VL results from V-DBS and FP-DBS were found to be comparable to plasma indicating that DBS can be used as an alternate sample to monitor the virological failure of ART patients. Introduction of DBS as an alternative specimen could expedite the rollout of routine VL testing services in Swaziland to include infants as well as access to patients from hard-to-reach health facilities.

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Reaching the Third 90: Key Findings from Facility Assessment on Readiness to Scale-up Routine Viral Load Testing in Swaziland

This poster, from Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale—a PEPFAR-supported meeting convened in 2016 to advance the scale-up of viral load (VL) services in sub-Saharan Africa—describes a facility readiness assessment conducted in 24 high volume VL roll-out sites in Swaziland. The assessment objectives were to establish baseline facility readiness to roll out viral load (VL) implementation, to assess site-level VL testing characteristics, and to give feedback to mentors to prepare sites for implementation. Conclusions and way forward include the recommendation that capacity of health care providers should be enhanced and facility-specific action plans should be developed by regional mentors—working with the Swaziland National AIDS Programme (SNAP) to access the facility findings, and the national routine VL implementation plan and tools will be finalized and should be adopted at the facility level.

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Reaching the Third 90: Routine Viral Load Scale-up Readiness in Swaziland: Laboratory Perspective

This poster, from Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale—a PEPFAR-supported meeting convened in 2016 to advance the scale-up of viral load (VL) services in sub-Saharan Africa—describes a context analysis for laboratory readiness and capacity to conduct VL testing to reach the third 90 in Swaziland. To be able to absorb the anticipated increased demand for VL testing, the Swaziland National Molecular Reference Laboratory (NMRL) initiated preparations to ensure adequate capacity for collection, processing, referral and analysis of VL samples. The results highlight programmatic strategic approaches related to equipment and testing capacity, VL sample collection and referral system capacity, national leadership and harmonization of efforts, and lessons learned.

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Reaching the Third 90: Lessons Learnt in the Early Phases of Implementing an m-Health Platform for the Notification and Retrieval of Viral Load Test Results in a Limited Resource Setting

This poster, from Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale—a PEPFAR-supported meeting convened in 2016 to advance the scale-up of viral load (VL) services in sub-Saharan Africa—describes challenges in Swaziland including a weak results notification system that increases the turnaround time for results delivery and linkage into care and treatment with high rates of patient loss to follow up. An m-health platform allowing for real-time entry of patient demographics, appointment scheduling and reminders, automated SMS notification of patients on availability of results, tracking of mother-baby pairs, and retrieval of viral load results at facility level was pilot tested. Initial results recommend modification and expansion of the m-health platform to cover more HIV care and treatment sites across Swaziland.

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Reaching the Third 90: Implementing Routine Viral Load Monitoring in Tanzania

This poster, from Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale—a PEPFAR-supported meeting convened in 2016 to advance the scale-up of viral load (VL) services in sub-Saharan Africa—describes Tanzania's experience implementing routine VL monitoring. It summarizes the laboratory systems for VL monitoring, as well as clinical, program, and M&E systems and engagement of patients and communities. Key next steps and way forward in Tanzania are highlighted.

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Reaching the Third 90: Implementing Routine Viral Load Monitoring in Uganda

This poster, from Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale—a PEPFAR-supported meeting convened in 2016 to advance the scale-up of viral load (VL) services in sub-Saharan Africa—describes Uganda's experience implementing routine VL monitoring. It summarizes the laboratory systems for VL monitoring, as well as clinical, program, and M&E systems and engagement of patients and communities. Key next steps and way forward in Uganda are highlighted.

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Reaching the Third 90: Implementing Routine Viral Load Monitoring in Zambia

This poster, from Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale—a PEPFAR-supported meeting convened in 2016 to advance the scale-up of viral load (VL) services in sub-Saharan Africa—describes Zambia's experience implementing routine VL monitoring. It summarizes the laboratory systems for VL monitoring, as well as clinical, program, and M&E systems and engagement of patients and communities. Key next steps and way forward in Zambia are highlighted.

image of poster. download PDF for alt-text

Reaching the Third 90: Implementing Routine Viral Load Monitoring in Zimbabwe

This poster, from Reaching the Third 90: Implementing High Quality Viral Load Monitoring at Scale—a PEPFAR-supported meeting convened in 2016 to advance the scale-up of viral load (VL) services in sub-Saharan Africa—describes Zimbabwe's experience implementing routine VL monitoring. It summarizes the laboratory systems for VL monitoring, as well as clinical, program, and M&E systems and engagement of patients and communities. Key next steps and way forward in Zimbabwe are highlighted.