Baylor Eswatini

Over the past few years, public health guidelines have shifted with regard to when antiretroviral therapy should begin. Before, someone newly diagnosed with HIV might not begin ART right away if the patient’s immune system is considered strong. The cost of treatment, particularly in poor countries, had been a factor. In 2015, the WHO issued new global guidelines: Every person with HIV should begin ART right away, a practice known as “test and start”. Working with the government and other partners, Baylor Swaziland has put the new recommendations into action, ensuring that HIV-positive individuals begin ART within one month of diagnosis. In this way, we have scaled up ART coverage from 72% at the beginning of the 2016-2017 year to 98% by the end.

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We have also continued our “in-reach” programme, with support from UNICEF, in which our clinicians follow up with patients who miss appointments by phone and home visits. This effort has reduced ART lost-to-follow-up patients from 2.3% to less than 1%.