Ana Lorena Guerrero Torres

This session covered community-led initiatives in four countries (India, Indonesia, Venezuela and Vietnam) to improve monitoring of TB/HIV, Hepatitis C self-testing and addressing issues of rights and social justice. Additionally, speakers highlighted TB testing initiatives for children in Nigeria and the integration of services in primary care in Ukraine.

Alberto Nieves (ACCSI) presented a community-led monitoring program in Caracas, Venezuela, which tracked TB/HIV comorbidities amid political challenges. This initiative involved people with HIV in data collection/dissemination through public dashboards, filling crucial data gaps. Giten Khwairakpam (amfAR’s TREAT Asia program) described community-led projects in Indonesia and India, which went beyond supporting essential health services for HIV and hepatitis, resolving treatment bottlenecks, supporting home-delivery of ARTs, and linking children to education programs. Ogheneuzuazo Onwah (ECEWS Nigeria) discussed an initiative using urine lipoarabinomannan for TB testing among children with AHD. Implemented in two Nigerian states, this initiative increased TB testing uptake from 11% to 69%, addressing the diagnostic challenges posed by conventional methods. Bao Vu Ngoc (PATH) described integrating HCV self-testing into HIV and harm reduction services in Vietnam. This study found that this testing, particularly through community-based organizations, increased testing uptake among key populations and people with HIV, reaching high-risk, underserved groups and linking them to care. Eteri Machavariani (Yale School of Medicine) presented a study in Ukraine integrating HIV, TB, and addiction treatment services in primary care clinics, showing higher quality health indicators for patients in these compared to standard treatment centers, showcasing the benefits of decentralized and integrated care.

This session emphasized the critical role of community-led and integrated approaches in improving services for people living with and at risk of TB, HIV, hepatitis and substance use. By involving communities and integrating services, these initiatives overcame various political and social challenges. The session also shows us how we need to advocate for sustainable funding models and further research to optimize the uptake and impact of these interventions. Research is needed to understand how to scale successful models and explore the systemic barriers to implementation.