Background: With an HIV prevalence of 2% and ART treatment coverage of 26%, Angola faces significant challenges to ensure timely HIV diagnosis and access to treatment for people living with HIV (PLHIV). As part of a national effort to improve treatment coverage, the Angolan National AIDS Institute (INLS), with the support of ICAP at Columbia University, designed a phased implementation plan of the Test and Treat (T&T) strategy launched at 15 Health Facilities (HF) in Luanda province in January 2018. As part of the phase 1 scale-up plan, INLS conducted an evaluation of early implementation results and identified lessons learned to inform national roll-out.
Methods: INLS reviewed retrospective aggregate data from the HTS and ART registers at the 15 HF. Data from pre and post implementation (November 2017 and August 2018 respectively) were analyzed to assess changes in HIV diagnosis, linkage to care and treatment among those tested HIV positive and timing of ART initiation.
Results: The number of individuals with a new HIV diagnosis was comparable pre and post T&T (837 in Nov 17 and 843 in August 18). Following T&T implementation, linkage to care increased from 59.7% (500/837) in November 2017 to 80.9% (682/843) in August 2018. Linkage to treatment improved from 51.9% (435/837) to 75.1% (633/843). Following the launch of T&T, 60% of all patients initiating ART did so on the same day as diagnosis, and 88% initiated ART within 15 days of diagnosis.
Conclusions: Results of T&T implementation demonstrate important improvements in linkage to care and treatment, including rapid ART initiation, aligned with the WHO guidance. Further evaluation of the impact of T&T implementation on health facility burden and patients'' outcomes is needed, including impact of T&T on retention and viral suppression, considering INLS is scaling up T&T implementation to 2 new provinces by January 2019.

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