In Kenya, adolescents and young people living with HIV (AYPLHIV) account for approximately 20% (303,700) of all people living with HIV (Spectrum Estimates, 2015; Kenya HIV Estimates 2015 Report). AYPLHIV (aged 10-24 years) face especially complex challenges dealing with a chronic illness amidst the physical, emotional and psychological developmental changes of transitioning from childhood to adulthood. The Operation Triple Zero (OTZ) initiative engages AYPLHIV as active stakeholders and partners in their health by promoting a responsive service delivery model.
The establishment of viremia clinics was an initiative to address the gaps and challenges in the monitoring and management of patients with high VL, and function as a form of differentiated care for unstable clients with high VL. Held at least one day a month, the viremia clinic utilizes a multidisciplinary team (MDT) model and focuses on enhanced case management and a patient-centered approach. This model is aimed at identifying patient-specific adherence barriers and tailoring interventions to address the patients’ specific needs. Patients are empowered to make joint decisions with their providers to improve their ART adherence.
The Bukoba Combination Prevention Evaluation (BCPE) in Tanzania has an innovative, peer-delivered, linkage-case-management (LCM) program for people 18-49 years old who are diagnosed in community and clinical settings. Through LCM, HIV-positive patients receive a package of peer-delivered linkage services recommended by the International Association of Providers of AIDS Care (IAPAC), the U.S. Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO). The standard set of linkage-to-care recommendations helps ensure all people living with HIV (PLHIV) enroll in care in a timely manner.
Through community-based testing, HIV-infected clients are provided baseline clinical care and a comprehensive package of peer-delivered linkage services recommended by the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC). CommLink mobile clinical and linkage services initiated at the point of HIV diagnosis are designed to help community clients “link” to a local facility for lifetime HIV, care, treatment, and support.