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Sub-Saharan Africa continues to bear a disproportionate burden of the global HIV epidemic. Integrating HIV services into primary healthcare is a crucial strategy to accelerate progress towards ending the epidemic. However, several challenges hinder effective integration, including underfunding, human resource shortages, infrastructure limitations, weak health systems, and sociocultural factors. With this perspective, we discuss strategies to address these challenges. A comprehensive, multi-faceted approach is necessary to overcome these barriers. Investing in human resources, improving infrastructure, and strengthening health information systems are essential for strengthening the health system. Implementing patient-centered care, integrated service delivery models, and community engagement can optimize service delivery. Utilizing digital health tools, such as mobile health applications and electronic health records, can enhance service delivery and data management. Mobilizing for an increase in domestic resources, aligning donor funding, and using cost-effective approaches are crucial for effective financing. Finally, robust monitoring and evaluation systems are necessary to track progress, identify challenges, and inform decision-making. With these strategies, among many others, sub-Saharan African countries can significantly improve the integration of HIV services into primary healthcare, leading to better health outcomes for people living with HIV and more sustainable HIV programs. [ABSTRACT FROM AUTHOR]

Background: Rwanda has made remarkable progress in scaling up HIV testing, treatment, and healthcare services. Recent data show that 95% of people living with HIV (PLWH) were aware of their status, 97.5% of them are on antiretroviral therapy (ART), and 98% of those who are on treatment have achieved viral suppression. Importantly, growing body of evidence supports the Undetectable = Untransmittable (U = U) concept, affirming that PLWH who maintain an undetectable viral load do not transmit HIV to their sexual partners. This pivotal breakthrough in HIV care has transformed public health strategies and stigma reduction efforts. This study aimed to explore the perspectives of PLWH on the U = U concept in health facilities in Rwanda. Methods: An exploratory qualitative study was conducted at three purposively selected health facilities in Rwanda from December 1 to 30, 2023. An interview guide was used to collect data, and data saturation was reached after enrolling 43 PLWH. The data was analyzed using conventional thematic analysis. Results: The majority of participants demonstrated good knowledge of HIV transmission, with the U = U concept being particularly well-understood among discordant couples and individuals who have been on treatment for over 10 years. Three themes emerged from the analysis: [1] comprehensive knowledge of HIV transmission among PLWH; [2] reasons for disclosing HIV status and linking to care; and [3] acceptability of the U = U concept. Conclusion: Our findings highlight the necessity for broader dissemination of the U = U concept across all PLWH subpopulations. Further research is essential to better understand the challenges faced by PLWH, which is critical for achieving the UNAIDS goal of ending the HIV/AIDS epidemic by 2030. [ABSTRACT FROM AUTHOR]

Rift Valley fever (RVF) is a devastating zoonotic mosquito-borne viral hemorrhagic fever disease that threats human and animal health and biodiversity in Africa, including in Rwanda. RVF is increasingly outbreaking in Africa, leading to devastating impacts on health, socioeconomic stability and growth, and food insecurity in the region, particularly among livestock-dependent communi-ties. This systematic review synthesizes existing evidence on RVF's epidemiology, transmission dynamics, and the prevention and control measures implemented in Rwanda. Our findings high-light the rapidly increasing prevalence of RVF and the expansion of its geographical distribution and host range in Rwanda. Furthermore, the review reveals gaps in local evidence, including the existence of competent vectors of RVFV and the risk factors associated with the emergence and spread of RVF in the country. This underscores the urgent need for prospective research to inform evidence-based health policymaking, strategic planning, and the development and implementation of cost-effective preventive and control measures, including diagnosis and surveillance for early detection and response. It also calls for the institutionalization of a cost-effective, multisectoral, and transdisciplinary One Health strategy for reducing the burden and risk of climate climate-sensitive and zoonotic diseases, including RVF, in the country. We recommend exploring cost-effective human and/or animal vaccination mechanisms for RVF, integrating AI-powered drones into dis-ease vectors surveillance and control, and the routine implementation of genomics-enhanced xenosurveillance to monitor changes in pathogens and vectors dynamics in order to inform poli-cymaking and guide the control interventions. [ABSTRACT FROM AUTHOR]