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Title
Using the young people and adolescent peer supporters (YAPS) model as a mechanism to decentralize HIV testing services and enhance linkage among adolescents and young people in Uganda
Presenter
Adoa Dennis
Authors
A. Dennis1, E. Magongo Namusoke1, T. Geofrey1, T. Evarest2, B. Hudson1
Institutions
1Ministry of Health, AIDS Control Program, Kampala, Uganda, 2The Clinton Health Access Initiative, Infectious and Non Communicable Diseases, Kampala, Uganda

BACKGROUND: In Uganda, progress across 95 95 95 treatment cascade for adolescents and young people (10-24) lags behind adults. By December 2019, 66% of adolescents and young people (10-24) knew their HIV status, 66% were on antiretroviral treatment (ART) and viral load suppression was 77%. This was largely attributed to absence of a differentiated peer led approach for adolescents and young people. The ministry of Health (MOH) adapted the Zvandiri CATS Model from Zimbabwe into the Young People and Adolescent Peer Supporter (YAPS) model for Uganda. This was premised on World Health Organization guidelines on Adolescents. This started as a pilot in 9 districts later scaled to 81 districts. Between July 2019- March 2020, 50% of Adolescents and Young Persons (AYPs) who received pre-test counselling by YAPS did not receive an HIV test. This created missed opportunities for identification of Adolescents and Young People Living with HIV (AYPLHIV).
DESCRIPTION: MOH decentralized HIV Testing Services (HTS) using YAPS model by reviewing National HIV testing policy to include YAPS as key service providers to screen, test and link AYPs into care. Extensive Consultations were conducted by MOH to collect views that informed policy. MOH developed HTS training manual for YAPS. Training of Trainers for 30 National YAPS resource persons was conducted. MOH piloted training of the YAPS as HTS lay testers for 5 days in the 9 pilot districts with high HIV burden among adolescents 10-24 Years. Training topics included promoting HIV testing among adolescents, HIV Self Testing among adolescents, counselling in the context of HIV testing, Linkage to care and Assisted Partner notification. Regular mentorships and support supervision were also conducted by the ministry.
LESSONS LEARNED: By March 2022 AYPs tested for HIV by YAPs was 57,215 compared to 68,213 in 2020 march. HIV positivity yield was at 2,14% compared to 1.48% in 2019, AYPs initiated into care increased from 79% in 2020 to 94% in 2022 and Linkage increased from 93% in 2020 to 95% in 2022.
CONCLUSIONS: The YAPS model when scaled up can be utilized as an approach for decentralizing HTS and contribute to closing the gap on the 1st 95.