Data accessibility as a barrier towards achieving the UNAIDS 90-90-90 goals in the HIV cascade of care among men who have sex with men (MSM) in Buenos Aires, Argentina

N. MORANDO; N. LAUFER; M. VILA; G. KOGAN; R. MARONE; L. SQUIQUERA; C. OCHOA; M.V. IANNANTUONO; H. SALOMON; M.A. PANDO

Paris

Congreso; IAS 2017 - 9th IAS Conference on HIV Science; 2017

Background: The HIV cascade of care has become an important tool for central assessment of treatment as prevention (TasP) strategy to stop the HIV epidemic. This study presents data of the HIV cascade among men who have sex with men (MSM) diagnosed with HIV in the main testing center for MSM in Buenos Aires, Argentina. Methods: Recruitment was done by spontaneous demand of rapid HIV test (RHT), available for free in the testing center (Nexo NGO) from April-2014 to March-2015. HIV diagnosis was performed with finger-stick samples (Alere Determine HIV-1/2) after signing an informed consent. During the post-test interview, confirmatory/complementary studies (Ag/Ab ELISA, HIV viral load and CD4T cell count) were offered to RHT-reactive-individuals. A blood sample was withdrawn by venipuncture from those who accepted and delivery of results was planned at 10 days. All RHT-reactive individuals were contacted (via email and/or mobile phone) one year after HIV diagnosis in order to collect information about retention in care, HAART and viral suppression. Results: 1496 MSM were tested at Nexo reaching an HIV prevalence of 12.5%. Among the RHT-reactive individuals, 83.4% (156/187) accepted to do confirmatory/complementary studies and 82.8% of them picked the results up, received counseling and were linked to care. A total of 62.0% had less than 500 CD4T cell/ml. At one year, 55.1% (103/187) could be contacted, 92.2% (95/103) were on HAART, 55.8% (53/95) remembered their last VL, and 83% (44/53) were virologically suppressed. The individuals that could not be contacted did not answer neither emails nor cell phone calls and messages. Conclusions: Our data reveals that the first steps in the engagement in care were successful with more than 80% of the individuals linked to care through the confirmation of reactive RHT, the picking up of the results and the visits to the physician. Among those whose data were obtained, high frequency of retention in care, HAART and virologically suppression was observed. However, efforts should be concentrated on increasing strategies to collect data in countries, like Argentina, where follow up information is not centralized in national data bases due to the coexistence of different health care systems.