Integrating HIV, SRH and Mental Health Services for Young People and Adolescents Living with HIV- End of Project Review

With less than a decade left to reach the global goal of ending AIDS by 2030, support and services for adolescents and young people living with HIV (AYPLHIV) need to be intensified. Despite wide availability of life-saving treatment, one out of 5 adolescents living with HIV in Zimbabwe (10-19 years) are not on treatment. Those who are on treatment face multiple challenges to adherence and retention, including stigma, mental health concerns, and poverty. Young mothers living with HIV are at particular risk of falling through gaps in health care services that are designed for adults. In 2016, the Government of Sweden, UNAIDS, UNFPA, UNICEF, and WHO launched a regional joint programme, 2gether 4 SRHR, to scale up the delivery of integrated services for HIV, sexual and reproductive health (SRH), and sexual and gender-based violence (SGBV). Zvandiri was selected as an implementing partner in Zimbabwe to improve the delivery of integrated services and achieve improved health outcomes for AYPLHIV and young mothers living with HIV.

Zvandiri’s programme is centered around clinic and community-based cadres, Community Adolescent Treatment Supporters (CATS) and Young Mentor Mothers (YMMs), who deliver in- person and virtual support to AYPLHIV and young mothers. The CATS and YMMs are 18-24 year old, trained and mentored peer counselors living with HIV who offer care and support services to their peers. Under the leadership of the Ministry of Health and Child Care and district-level health and social welfare officials, CATS and YMMs provide critical information and support to AYPLHIV, caregivers, sexual partners, family and community members on HIV, SRH, SGBV and mental health. CATS and YMMs deliver individual counselling, facilitate support group and community dialogue sessions, identify and refer those at risk or in need of further services, and follow up referrals to ensure AYPLHIV and young mothers receive a comprehensive package of health, child and social protection services.

During the project period, a total of 14,870 AYPLHIV and 786 young mothers were supported in 5 districts by 82 CATS and 46 YMMs. Final early infant diagnosis outcomes, established through HIV testing after the cessation of breastfeeding, was conducted for 396 babies and 11 (2.8%) received HIV positive results. Male partners were also tested and those found to be positive were initiated on to treatment. Health worker capacity was enhanced with the support of Zvandiri mentors and adolescent-friendly materials. With the COVID-19 pandemic, Zvandiri adapted its activities by increasing digital outreach, ensuring that its client-centered support continued.