BACKGROUND:
Kenya has made significant progress in stabilizing the HIV epidemic, prompting a national shift from standalone Comprehensive Care Clinics (CCCs) toward integrated, people-centered service delivery. Machakos Level 5 Hospital, home to one of the earliest CCCs established in 2003, has implemented HIV service integration in line with NASCOP guidance.

METHODS:
A retrospective programmatic review was conducted using routine facility data from KenyaEMR and service registers, covering the period from October 2024 to March 2025. Key indicators included treatment continuity (TX_CURR), treatment dynamics assessed through waterfall analysis, HIV Testing Services (HTS) cascade, viral load (VL) monitoring, cervical cancer screening outcomes, and PMTCT indicators including STAT, Early Infant Diagnosis (EID), and maternal VL cascades.

RESULTS:
The facility maintained a stable cohort of clients actively on antiretroviral therapy, with notable contributions from newly initiated clients, transfers-in, and return-to-treatment cases. HTS screening across service delivery points facilitated early case identification and linkage to treatment. Viral load uptake among eligible clients remained high, reflecting strong adherence to monitoring guidelines. PMTCT indicators demonstrated sustained HIV status ascertainment among pregnant women and consistent EID testing among HIV-exposed infants. Integration of cervical cancer screening within HIV services improved access to on-site treatment while strengthening referral systems for off-site care.

CONCLUSIONS:
Integrated HIV service delivery at Machakos Level 5 Hospital has enhanced continuity of care, optimized resource utilization, and sustained key treatment and prevention outcomes. These findings support national efforts to transition from vertical HIV programs to integrated health systems to ensure sustainability amid declining donor funding.