LAUSR

Background Adolescents living with HIV (ALHIVs) in high ALHIV-burden, resource-limited settings like Nigeria have significantly inferior outcomes from antiretroviral therapy. This paper expands on these inferior outcomes including inferior access to and coverage of ART, higher rates of loss to follow-up, poor adherence, increased needs for psychosocial support and sexual reproductive health services. This study reports on initiatives to identify and bridge gaps in achieving HIV suppression among Nigerian ALHIVs, and ensuring they are not left behind in the UNAIDS 90-90-90 targets. Methods A retrospective chart review was conducted for ALHIVs aged 10 to 19 years who attended IHVN facilities in Abuja from June 2017–July 2018 with viral loads ≥1000 copies/ml. Quality improvement projects known as ‘small tests of change’ to improve poor performing areas were initiated. This performance review initiative captured data on a template that highlights the Problem Statement, a Root Cause Analysis, Ideas Intended for Use, an Aims Statement, and a Plan Do Study Act (PDSA). This approach forms the basis of a monitoring cycle to track innovation and outcomes, which may be considered as failed, ongoing, or successfully completed. Results Inadequate ALHIV suppression was captured as the Problem Statement, the Root Cause Analysis highlighted challenges with - disclosure of HIV status, ART adherence, HIV/AIDS related stigma and transition to adult services. Some Ideas intended for Use included- Intensified Adherence Counselling, peer mentoring, and youth friendly services, while the Aims Statement was a need to implement initiatives that strengthen ALHIV suppression rates. The Plan Do Study Act (PDSA ) stages are currenlty - successfully completed and on going. Conclusion Attempts to address the needs of ALHIVs are burdened with many challenges, which are magnified in sub-Saharan Africa where HIV prevalence is high and resources are scarce. These report detail strategies initiated to ensure ALHIVS are not left behind in the UNAIDS 90-90-90 targets. Disclosure No significant relationships.