In Mauritius, Viv Pozitif works to keep people living with HIV in care: it analyses the barriers to staying in care and rolls out a community-based response to re-engage and treat people living with HIV who have been lost to follow-up.
Context
Mauritius’s HIV epidemic is concentrated and particularly affects key populations (people who inject drugs, sex workers, men who have sex with men and transgender woman). Although antiretroviral treatment is free, many patients disengage from care after starting treatment: they become “lost to follow-up” (LTFU). For lack of research, the causes of these breaks in care remain poorly documented. A fragmented care system, weak community roots and deep gender inequalities compound the barriers. Gender inequalities and gender-based violence heighten them further, particularly for women, including transgender women.
Description
Viv Pozitif combines research and action to lastingly re-engage patients lost to follow-up in the continuum of care, in the districts of Port-Louis and Pamplemousses. The project mobilises people living with HIV and community actors, and is built on three pillars:
- Understand: a baseline study identifies the barriers to and determinants of breaks in care, using gender-disaggregated data, to guide targeted interventions;
- Retain: a patient navigation programme provides one-to-one support to guide people into care, backed by differentiated service delivery (a mobile clinic and an upgraded care centre, the Centre Banian) and training for community actors;
- Reconnect: a digital, community-led tracking system locates and re-engages people lost to follow-up, with data sharing coordinated with public health services; an advocacy component and a U = U (Undetectable = Untransmittable) campaign round out the approach.
Impact
As the first study of its kind in Mauritius, it will generate evidence and national guidance to inform public policy and to outline a community-based model that can be replicated nationwide, in support of gender equity.
