Circle of Hope: Using faith-based community outreach posts to increase HIV case finding, linkage and retention on treatment in urban and rural settings in Zambia

Antiretroviral treatment (ART) coverage for people living with HIV (PLHIV) in Lusaka Urban District (the capital and largest city in Zambia) was estimated to be near 70 percent in January 2019, with lower coverage for children, men, and young adults. In March 2018, recognizing that growth in the HIV treatment program had plateaued, CoH leadership, in coordination with CRS, created a new model to identify PLHIV and immediately link to same-day ART initiation. Critical elements of the model include: its acceptability by the service utilizer, the location of the community posts, the stakeholder engagement of the local community, and the selection of local CHWs who know the geographic and social terrain of the surrounding community. After implementing the community post model, CoH saw immediate and sustained increase in HIV case identification. Ninety-two percent of HTS_POS from March 2018 – March 2019 reported by CoH were identified at the community posts; only 8 percent were from the central facility.

Ariel Adherence Clubs: Increasing Retention in Care and Adherence to Life-Saving Antiretroviral Therapy among Children and Adolescents Living with HIV in Tanzania

Ariel Adherence Clubs (AACs) have been implemented across 6 regions in Tanzania, at 105 facilities, since 2007 by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). AACs were designed to address the social and behavioral barriers to HIV treatment, retention, and adherence faced by children and adolescents. All participants in AACs are required to know their HIV status. As such, trained providers work with caregivers to facilitate disclosure of HIV status to children and adolescents. Psychosocial support groups for HIV-positive children and adolescents aged 5–19 are provided at AACs. Clubs are grounded in the belief that children and adolescents living with HIV (ALHIV) will achieve improved health outcomes when clinical services are complemented by high-quality social support and age-appropriate information about HIV infection, treatment, adherence, HIV status disclosure, positive living, and life skills needed for growing and aging into healthy, HIV-positive adults. The purposes of AACs are to improve participant antiretroviral treatment (ART) adherence and clinic retention, and provide psychosocial supports to adjust to living with HIV and transitioning into adulthood and adult HIV care.

Zvandiri: Peer Counseling to Improve Adolescent Adherence to Treatment and Psychosocial Well-being in Zimbabwe

The Zvandiri program, run by Africaid, began in Zimbabwe in 2004 as a support group for adolescents living with HIV. Community Adolescent Treatment Supporters (CATS),  HIV- positive people aged 18-24 years, work between health facilities and the homes of youth living with HIV (YLHIV) to increase uptake of testing, linkage, and retention in care, adherence, and services related to sexual and reproductive and mental health. Monthly community-based support groups, community outreach teams, and clinic-based Zvandiri Centers provide safe spaces for accessing clinical and social services and linking adolescents to other forms of assistance, while educating individuals on sexual and reproductive health (SRH) and life skills. Through these interventions, the Zvandiri program builds mental, emotional, and physical resilience.