1. Urgent need to strengthen continuum of HIV care after successful scale up of decentralized HIV care services: a prospective cohort study of newly diagnosed HIV clients in rural districts, Zambia Vincent Chipeta 1, S. Miyano 2, K. Komada 2,3, K. Chibwe 1, P. Nambala 4, F. Hadunka 4, A. Mwango 5 1. Kalomo District Community Medical Office, MCDMCH, Zambia, 2. National Center for Global Health and Medicine, Japan 3. SHIMA Project, JICA, Zambia 4. Kazungula District Community Medical Office, MCDMCH, Zambia 5. Ministry of Health, Zambia

2. Background & Method  The HIV prevalence among adults is 14.3 % in Zambia (2007 DHS)  Urban areas are typified by higher HIV prevalence (20%), however HIV prevalence in rural areas is also high (10%).  The government of Zambia commenced to provide ART at district Hospital in 2005 and scaled them up to several rural health centres in 2009.  A prospective cohort study of newly diagnosed HIV clients in Kalomo & Kazungula, rural districts, Zambia  All clients newly diagnosed as HIV positive at 8 health facilities (1 district hospital and 7 rural health centres) from April 2012 to March 2013 have been enrolled.  They were followed prospectively and assessed at the end of June 2013.

3. Results

5.  There is a big gap between HIV diagnosis and enrolment into HIV care as well as retention on HIV care  There is urgent need to strengthen continuum of HIV care after successful scale up of decentralized HIV care services Conclusions

6. Acknowledgement  Our patients  Treatment supporters  District Community Medical Offices  JICA-SHIMA project  NCGM  MCDMCH- Zambia  MOH- Zambia