The CQUIN network was well represented at IAS 2021, as network participants drew upon their experiences over the past year to showcase innovations, challenges, and triumphs related to the scale-up of differentiated service delivery in the context of the COVID-19 pandemic.  CQUIN convened three satellite sessions, showcasing network countries and partners.

Leveraging the Lessons of Differentiated Service Delivery (DSD) to Provide High-Quality Integrated Maternal and Child Health Services 

In March 2021, CQUIN convened a 21-country virtual meeting on DSD for breastfeeding and pregnant women living with HIV. Key themes from the meeting were reviewed at the satellite session, moderated by Elaine Abrams, MD, ICAP’s senior research director, and Fatima Tsiouris, MS, ICAP’s deputy director for Human Resources for Health Development. The satellite highlighted the gaps that CQUIN network countries face in expanding DSD services for pregnant and breastfeeding mothers including lack of data and the lack of involvement of recipients of care in policy planning initiatives intended for their benefit.  “Recognizing that DSD is more than just HIV treatment, DSD 2.0 highlights that care and treatment for individuals need to address other health needs including sexual reproductive health and other STI’s,” said Tsiouris. “For women, we need to be thinking about how to address their reproductive health needs along the life course to include family planning, child health, and postnatal services to optimize care. The critical objective is to achieve and maintain HIV viral suppression to maximize maternal health outcomes and prevent new vertical transmissions.”  The session also featured a dynamic debate between Aleny Couto, MD, Ministry of Health, Mozambique, and Angela Mushavi, MD, Ministry of Health and Child Care, Zimbabwe on whether all mother/baby pairs should be followed in a DSD Model as a unit. This discussion was followed by reflections from Robinah Babirye, an advocate for young people living with HIV in Uganda, who shared her experiences as a recipient of care and believes that mothers should be seen together with their children in her country.

“There are great models of success in integrating antenatal care and antiretroviral treatment services to achieve high antiretroviral therapy (ART) coverage,” Abrams said in conclusion, calling on country stakeholders to take their specific country context into consideration during the integration and implementation of maternal health services. “DSD care models can enhance MCH and HIV services in a bi-directional manner.”

Differentiated HIV Services for Mobile, Migrant and Displaced Populations

In this session chaired by Miriam Rabkin, MD, MPH, ICAP’s director for Health Systems Strategies, presenters discuss cross-cutting research and programmatic lessons learned on the relationship between mobility and HIV. Carol Camlin, PhD, MPH, Associate Professor at the UCSF School of Medicine, and Andrea Low, MD, PhD, Clinical and Scientific Director of the PHIA Project at ICAP Columbia discussed their research into the relationship between mobility and HIV risk. Case studies from Nigeria, Mozambique, and South Sudan explored the adaptations necessary to avoid disruptions in HIV services by natural disasters and civil unrest and provided recommendations for countries to design, deliver, and evaluate HIV services for mobile populations. “These diverse groups of people on the move are key populations for the HIV response, and epidemic control is not feasible without attending to their extraordinary circumstances,” said Rabkin.

Differentiated Service Delivery and COVID-19: Resilience, Innovation, and Lessons Learned

Over a thousand delegates joined this session moderated by Peter Preko, MB.ChB, MPH, CQUIN project director, who reviewed how the  21 countries in the CQUIN network adapted HIV service delivery models in response to the COVID-19 pandemic. Catherine Godfrey, MD, FRACP, presented data on the expansion of multi-month dispensing of HIV treatment from the U.S. President’s Emergency Fund for AIDS Relief (PEPFAR). Tiffany Harris, PhD, MS, director of ICAP’s Strategic Information Unit presented data on the resilience of HIV services (testing, antiretroviral therapy initiation, multi-month treatment dispensing, and viral suppression) during the pandemic in approximately one thousand ICAP-supported sites in 11 countries. Panelists from Rwanda, Uganda, Côte d’Ivoire, Ethiopia, and Nigeria presented case studies on the topic and participated in a live Q&A session with delegates.

All the presentations, abstracts, and sessions from IAS 2021 are available on the IAS conference website for registered delegates until August 18, 2021. All content will be available to the public starting in September.

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