Issue Sao Paulo has 43 million inhabitants, 645 cities, 251.133 reported AIDS cases. Despite the HIV low prevalence in our state (0.5%). The HIV rapid diagnostic testing method (RDT HIV) universal implementation is considered a very important strategy to increase access of vulnerable populations to HIV diagnosis together with other focused strategies. The goal was to implement the RDT HIV in at least one health public service in all 645 municipalities. In Brazil, we have the Health Unic System SUS as an universal public health system.

Description Between 2006–2016, around 500 trainers trained approximately 10.000 health professionals. From 2010 to 2016, the STD/AIDS Program Coordination trained 800 facilitators during the decentralisation process. In 2016 586 municipalities implemented RDT HIV besides conventional testing (91%); 60% in primary care units. As proxy of HIV performance, we focus HIV annual campaigns carried out in the state since 2008 considering the majority adherence of municipalities (91% in 2016) and health services. 7000 rapid diagnostic HIV tests in 2008;18 000 in 2009; 35 000 in 2010; 40 000 in 2011; 40 000 in 2012; 1 56 000 in 2013; 2 47 000 in 2014; 2 51 000 in 2015.

Lessons learned: Training of professionals through the training of trainers has boosted the implementation of HIV RDT. Monitoring RDT HIV implementation through five macro-regional meetings was fundamental to find out and discuss local obstacles to offer access to HIV testing without having to schedule. Most vulnerable population for HIV continues to seek out ST/AIDS referral services for testing. Primary health care health workers have difficulty delivering positive HIV test results. Performing extra-mural actions is easier when the health unit has already implemented the test in its routine.

New steps Priorities for 2017: Continue the implementation process among all primary health care services. Expand and focus HIV testing In places of concentration and socialisation of more vulnerable groups such as gays and transvestites. Support outreach-testing activities by NGOs.