Up to 42 % of PLHIV Tested for Viral Load Left Without Results in Bugesera, Gasabo and Rwamagana.

Between march and May 2025, the ICLM for HIV, TB and Malaria Pilot conducted in selected health facilities across Bugesera (Nyamata , Mayange , Gashora , Ruhuha), Gasabo (Kinyinya, Gikomero, Kagugu, Gihogwe ), and Rwamagana (Avega, Rwamagana, Mwulire, Nzige) uncovered a critical service gap affecting People Living with HIV (PLHIV). While viral load testing was actively conducted :76% of clients in Gasabo, 65% in Rwamagana, and 48% in Bugesera reported testing within the last six months , an average of 42% of those tested did NOT receive their results.
“They took my blood and told me to continue my treatment. I never heard what the result was.”— Male client, ICLM Pilot
Rwanda’s national HIV guidelines clearly require that healthcare providers communicate viral load results to clients as part of routine care. Viral load testing is the backbone of HIV treatment monitoring. It determines whether treatment is working, confirms viral suppression, and protects both the individual and the community. Without results, the purpose of testing is lost.
When results are not returned:
– Clients cannot know whether their treatment is working.
– Adherence counselling cannot be properly tailored.
– Early signs of treatment failure may go undetected.
– They will not understand Undetectable =Untransmittable
The iCLM pilot findings show that the testing system itself is functioning, samples are collected and processed but the feedback loop is breaking at facility level. Blood is drawn. Laboratories analyze. Yet the final and most important step returning results to the client is often missing.
A test without results is not monitoring; It is a missed opportunity for empowerment and prevention.

Closing this gap requires structured result-return systems, clear accountability at facility level, tracking mechanisms to ensure every test ends with documented feedback, and patient-centered follow-up when results are delayed.

Viral load testing is not complete when the sample is taken. It is complete when the client receives their result.

Read the full ICLM Pilot Consolidated Report to explore district-level findings and recommended corrective actions.

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