RT Journal Article
SR Electronic
T1 Effects of a Peer-Led Intervention on HIV Care Continuum Outcomes Among Contacts of Children, Adolescents, and Young Adults Living With HIV in Zimbabwe
JF Global Health: Science and Practice
JO GLOB HEALTH SCI PRACT
FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs
SP 575
OP 584
DO 10.9745/GHSP-D-19-00210
VO 7
IS 4
A1 Tapera, Talent
A1 Willis, Nicola
A1 Madzeke, Kudakwashe
A1 Napei, Tanyaradzwa
A1 Mawodzeke, Mather
A1 Chamoko, Stanley
A1 Mutsinze, Abigail
A1 Zvirawa, Teddy
A1 Dupwa, Beatrice
A1 Mangombe, Aveneni
A1 Chimwaza, Anesu
A1 Makoni, Talent M.
A1 Mandewo, Winnie
A1 Senkoro, Mbazi
A1 Owiti, Philip
A1 Tripathy, Jaya Prasad
A1 Kumar, Ajay M.V.
YR 2019
UL http://www.ghspjournal.org/content/7/4/575.abstract
AB An intervention focused on children, adolescents, and young adults living with HIV using a cadre of dedicated peers—community adolescent treatment supporters—led to improvements along the HIV care cascade among their household contacts and sexual partners.Background: Africaid Zvandiri, in partnership with the Ministry of Health and Child Care (MOHCC) in Zimbabwe, implemented a comprehensive, peer-led program, focused on children, adolescents, and young adults living with HIV aged 0–24 years. The peers, known as community adolescent treatment supporters (CATS), are people living with HIV (PLHIV) aged 18–24 years who are trained and mentored to support their peers throughout the HIV care continuum through support groups, home visits, phone call reminders, and messages. We report the HIV care continuum outcomes (HIV testing uptake, antiretroviral therapy [ART] uptake, retention, and viral suppression) in a cohort of household contacts and sexual partners (aged younger than 25 years) of index children, adolescents, and young adults living with HIV identified by CATS from October 2017 to September 2018 in 24 districts of Zimbabwe.Methods: This was a retrospective cohort study involving analysis of routine program data, extracted from electronic databases consisting of data on contacts of index PLHIV and ART outcomes. We used April 30, 2019, as the censor date for all analyses.Results: A total of 15,223 household contacts and sexual partners with unknown HIV status (linked to 9,353 index PLHIV) were identified and referred for HIV testing. Of these, 12,114 (79.6%) were tested and 1,193 (9.8%) were HIV-positive. Of the latter, 1,153 (96.6%) were initiated on ART with 99% starting on the day of diagnosis. Of those on ART, 1,151 (99.8%) were alive on ART at 6 months and 2 (0.2%) died. A total of 1,044 (91%) children, adolescents, and young people living with HIV underwent viral load testing at 6 months or later, of whom 1,037 (99.3%) were virally suppressed (<1000 copies/ml).Conclusion: These findings add to the global evidence demonstrating the effectiveness of peer-led interventions in children, adolescents, and young adults living with HIV and justify the decision of the MOHCC in Zimbabwe to scale-up the model nationally. Future research should aim to understand the reasons for the gaps in HIV testing and viral load testing using qualitative research.