Strengthening Universal Health Coverage by Overcoming the Challenges of Equity and Access to Healthcare, Through a Mobile Multi- and Transdisciplinary Team for HIV Infection Management: <i>A Formative Evaluation of a Strategy Implemented in Goudomp H

Abstract Located in southern Senegal, Goudomp covers 23.9% of the Sedhiou region territory. It was home to the largest number of people living with human immunodeficiency virus (PLHIV) in Sedhiou, as well as one of the hottest spots in this border region. Faced with this threatening situation and the scarcity of resources, the Goudomp health authorities implemented a strategy to improve equity and access to healthcare through a mobile multi- and transdisciplinary team for HIV infection management (M2T2-HIV). Thus, in less than a year, the strategy boosted HIV screening by 10.5%, while increasing the proportion of voluntary screening campaigns from 42.7 to 79.5%, with a particular focus on vulnerable groups (MSM, sex workers, injecting drug users and people living with a disability). Antiretroviral treatment initiation and drop-out rates improved, respectively, from 73 to 94% and from 72.7 to 30%. Finally, M2T2-HIV not only boosted TB-HIV co-infection detection by 46.2%, but, above all, reduced the death rate among those recently screened for HIV and HIV-positive patients on ART from 21 to 15% and 31 to 18%, respectively. Nevertheless, there remain major challenges, hence the need to extend the strategy to other diseases in order to better combat the co-morbidities that kill more PLHIV. Information © The Authors 2025