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TREAT all in COTE D’IVOIRE
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  1. TREAT all in COTE D’IVOIRE Serge Paul EHOLIE • Affiliations: • Département de Dermatologie-Infectiologie, UFR des Sciences Médicales, Université Félix Houphouet-Boigny, Abidjan • Service des Maladies Infectieuses et Tropicales , CHU Treichville, Abidjan • Programme PACCI-ANRS de recherche en Côte d’Ivoire

  2. Epidemiology of HIV in Côte d'Ivoire * HIV prevalence: 3.7% (EDS III CI 2012) * Estimated HIV-Infected people: 461 831(Spectrum 2015) (ratio W/M: 1,5) - Adults ~422 147 - Children ~ 39 683 * Coverage of HIV testing: 253 577 (55%), march 2016  Gap: 206 423 * Coverage of ART, if treat all: 166946, (36%), march 2016 * Coverage of VL: 19% * Suppressed VL: 14%

  3. HIV Cascade in Côte d'Ivoire

  4. HIV facilities in Côte d'Ivoire

  5. ART guidelines in Côte d'Ivoire , when to startRevised in march 2015 (2013 WHO guidelines) *CD4 < 500 cells/mL; * At any CD4 if - WHO clinical stage 4; - TB co-infection; - HBV Co-infection (severe liver disease); - Pregnant women; - Serodiscordant couples: - Key populations (HSH, SW, DU)

  6. Treat all in Côte d'Ivoire Goals: • Increase the number of HIV infected patients receiving ART; • Reach rapidly 90-90-90 and control HIV epidemic in the country • Decrease rapidly HIV new infections and AIDS related deaths

  7. Treat all in Côte d'IvoireObjectives • Expected results (2020) • Reduce HIV new infections to 31% • Reduce HIV related mortality to 75%

  8. Treat all in Côte d'Ivoire Treat all but be realistic, Schedule to start in Q1/Q2 2017 Review HIV testing strategies, involve the coummunity, target the hiden population (men++++) Improve retention un care (65% at M12) Set up test and treat in specific populations (cf 2015 guidelines); Review forecasting in order to avoid drugs stock out; Strenghten integrated approach; Set up task shifting in the whole country (recommended since 2015); Increase the budget allocated to testing, treatment and viral load

  9. Merci pour votre attention