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.
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.