Dorian Gule

1016: Men Interrupted: Strategies to reduce high rates of treatment interruptions among men who have sex with men (MSM) in South Africa Dorian Guleo OUT started in 1994 - 2nd oldest LGBT NGO in South Africa. [...] o Engage Men’s Health (EMH) program funded by USAID/PEPFAR under FHI EpiC project. [...] o EMH provides comprehensive HIV prevention and treatment services for MSM in 3 metros. 1 clinic and mobile services (10 teams). o Has provided HIV testing to 58,671 MSM, initiated 14,698 on pre-exposure prophylaxis (PrEP), and 3,375on antiretroviral therapy (ART). [...] One of the largest African HIV programs for MSM. [...] Abstract Description o Motivational interviewing, tailored adherence counselling, multi- month dispensing (MMD) based on client needs and intersecting syndemic vulnerabilities. o Analysis of client visits: While 57% of the Y1 cohort of 510 retained ART clients experienced at least one IIT, only 32% had IIT in Y2 o While the number of clients experiencing IIT decreased, the interruption durati [...] o As 45% of the Y2 cohort was also in the Y1 cohort, median days on ART were significantly higher in the Y2 cohort (699 vs 341 days), suggesting duration on ART may contribute to decreased IIT. [...] o As viral load monitoring is only indicated for clients retained in uninterrupted care (≥4 months), we cannot assess the impact of IIT on VS rates. 291 198 57% 32% Y1 Y2 No. of ITT % of ITT n = 510 n = 627 Y1: Oct 2021-Sep 2022 Y2: Oct 2022- Sep 2023What have we learned? [...] Differentiated client- centric approaches to promote adherence Psychosocial support (PPS) Individualized Multi-month dispensing Real-time data use should be used to identify clients needing additional support. [...] Reduce IITRecommendations o Programs should assess and address external factors affecting clients’ ability to adhere to ART due to intersecting vulnerability (stigma, drug use, housing insecurity, unemployment). [...] o By establishing approaches and systems to promote open and non-judgmental adherence counselling, enhanced re-engagement efforts, individualized MMD, and PSS, IIT can be prevented.Thank you.