Saturday, April 20, 2024
4/20/2024
Tajikistan has made limited progress towards the first 95, with only about 62% (7,465) of total estimated PLHIV 15+ (12,000/2018 Spectrum estimate) receiving an HIV diagnosis. The country still has not yet diagnosed an estimated 4,535 PLHIV 15+, and many of these are likely long-term external migrants, current or former KP, and their sexual partners. Tajikistan has made significant progress towards the second 95 since 2015, with nearly 82% of those diagnosed on ART as of January 2020. The bigger progress toward the 2nd and 3rd of 95-95-95 targets for HIV treatment scale-up is constrained primarily by limited case finding as well as by difficulties to link and retain patients on treatment. Under this project, RAC will continue to implement the activities at the national and sub-national levels, guided by the recent available HIV data. Site-level activities will be supported in the SNUs with the highest burden of HIV. The priority SNUs for FY21 are: (1) Dushanbe City; (2) Sughd Region; and (3) Districts of Republican Subordination surrounding Dushanbe. These SNUs include approximately 69% of all estimated adult PLHIV in Tajikistan. RAC will also provide technical above-site support for the AIDS centers throughout the country. With technical support from CDC, RAC will enhance the epidemiologic investigation of newly diagnosed PLHIV in order to tailor case finding through an improved understanding of the local epidemiology and identification of pockets of unfound cases. The enhancements will include better risk elicitation to identify probable mode of transmission, improved partner elicitation and use of recency testing to identify newly infected PLHIV. The primary focus will be on: 1) improving case finding and linkage from testing to treatment; 2) ensuring that those PLHIV on treatment are adherent to treatment and retained; 3) reducing number of LFTU; 4) and improving treatment outcomes. RAC will expand recency testing nationwide for all newly diagnosed HIV cases. Index testing services will be offered to all eligible patients, including newly diagnosed with HIV and previously diagnosed but not virally suppressed. RAC will make sure that all index testing services meet WHO’s 5C minimum standards, including consent, counseling, confidentiality, correct test results, and connection to HIV prevention (for both HIV-positive and HIV-negative individuals). Among KPs, RAC will implement optimized case-finding model under which representatives from KP communities (mainly PWID) will be asked to bring for testing up to three members from their network who they think could be at risk of HIV. HIV self-testing will be implemented with those unwilling or unable to access current HIV testing services. To reduce LTFU and improve retention, RAC will prioritize 35- to 50-year-old males, who accounted for 54% of all LTFU in 2019. RAC will work on resolving barriers to retention experienced by KPs, who also have a high rate of LTFU. Through this targeted approach, RAC intends to increase HIV testing yield and more effectively and efficiently find new HIV cases, improve linkage and same day or rapid treatment initiation, reduce LTFU rates significantly to below 10%, and improve retention to over 95% in PEPFAR-supported SNUs. There will be greater emphasis on national scale-up of key activities such as index case testing, multi-months dispensation (MMD), same-day or rapid ART initiation, TLD transition, and point of care use of recency assay testing.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
