ID: HR19-292

Presenting author: Christopher Baguma

Presenting author biography:

Chris is a harm reduction advocate in Uganda, with an experience over 6 years in HIV and Harm Reduction. I am currently the programs Manager Uganda Harm Reduction Network and the Acting regional Coordinator of Eastern African Harm Reduction Network

Trend analysis of HIV/TB integrated services utilization and coverage in Uganda Harm Reduction Referral Points in Kampala, Gulu, Mbarara and Mbale

Christopher Baguma

Background: TB and HIV co- infection places patients at sharply increased risks of mortality and morbidity. Strengthening access to TB/HIV co- infected patients with needed ART and TB treatment and monitoring is a priority to health service partners. Through implementation of the HIV and Harm Reduction Project in Uganda, a Global Fund-funded project started in 2016. Most at Risk Population Initiative through its regional branches has been providing health services for People who use and inject drugs.

Methods: Using routine aggregate HIV/TB program data, an observational, one year trend analysis was conducted in January 2017. Quarterly health facility TB/HIV reports were the data sources. TB/HIV integrated services indicators analysed included: number of TB registered cases, percentage of TB cases tested for HIV, HIV positivity rate among TB patients, percentage of TB cases who were started on cotrimoxazole prophylaxis, and percentage of TB/HIV co-infected started on ART.

Results: From January 2016 to December 2016, the number of TB registered cases varied between 350 and 700 per quarter. The analysis revealed an increasing trend in HIV test coverage in TB registered patients (from 41% in the first quarter of 2016 to 70% in December 2016); a similar pattern was observed in cotrimoxazole prophylaxis initiation (53% to 90% in the same period).

Conclusion: Although this trend analysis has limitations to establish causation, the implementation of HIV and Harm Reduction Project in 4 districts of Uganda and the expansion of ART services with integrated TB services for Drug users has contributed to a scale-up in TB/HIV services utilization in other referral MARPI points in other districts. HIV patients have obtained growing access to TB services over time and TB/HIV co-infected patients are being identified and are more widely accessing ART, which will undoubtedly have a positive impact on health outcomes.