SUGGESTIONS FOR PNS SCALE UP

 Intensifying elicitation of sexual partners of index clients from;

 Newly diagnosed HIV positive clients
 High VL/ Low viremia
 PMTCT mothers
 Discordant couples
 Adolescents
 Rota for PNS activities
 Allocating more days weekly in the Rota for PNS activities
 Uptake of PNS to be engaged at all points of service delivery in the facility i.e. HTS
rooms, registration desk, triage, clinical room

CHALLENGES PNS CASCADE ACHIEVEMENT

 Far distance social contacts
 During elicitation of social contacts from the index clients for PNS, Ladies
mostly give information of their sexual partners from far distance – Kisumu,
Mombasa, Nakuru.
 False locator information from the index clients about their sexual contacts; -
 Clients not giving most current location/residence and phone numbers of
the sexual contacts identified for PNS activities.

SCALE UP OF SUPPRESSION RATE

 Enhanced adherence counseling (EAC)
 Short TCAs
 Health talks at every visit

CHALLENGES
 Delayed disclosure
 Peer pressure for the adolescents
 Stigma mostly from the adolescent

LOW RETENTION RATE

 Distance to the facility – travel rearrangements and Public Service Vehicles
compliance issues make clients opt for transfer out to the facilities that are nearer to
them.
 Change of place of work – transfers of some of the clients from Migori to other
towns
 Relocation – clients moving back home due to loss of job, post - election violence,
Migori being on of the hot spots for election violence
 Lack of provision for OI drugs and Lab tests
 Devolved HIV care centers/units
  Herbal medicinal – clients seek herbal treatment from herbal ‘doctors’ who have
stationed their bases in the major towns closer to them e.g. Migori, Kisumu, Busia
unlike before where these could only be sought across the neighboring countries
Tanzania, Uganda. The advertisements for the availability of the services are made in
the local languages at the local FM stations.

SUGGESTIONS FOR HIGH RETENTION RATE

 Registration mostly of clients from catchment areas
 Morning health talks
 Budget allocation for OI drugs and lab tests by KCCB – KARP
 Reducing waiting time for clients with viremia – cut off copies of viremia.