Zvandiri has a long history of supporting and developing paediatric and adolescent HIV guidance, training curricula and tools, to inform and guide the delivery of quality, child and adolescent-focused HIV services. Working together with the Government of Zimbabwe and young people living with HIV, a wide range of creative materials have been developed to support children and adolescents, and those that care for them, to have the knowledge and skills they need.
On 6th May 2021, The World Health Organization (WHO) launched its new HIV service delivery guidelines, marking a significant step for adolescents worldwide. As part of the review of the guidelines it was unanimously agreed that psychosocial support is not only helpful, but it is critical in improving HIV outcomes amongst adolescents living with HIV.
This new guideline was informed by a systematic review which assessed the effect of psychosocial interventions on ART knowledge, linkage to care, adherence to ART, retention in care, viral load, sexual and reproductive health behaviour and knowledge and improved transitioning to adult services. Thirty randomized control trials were reviewed; two of these trials were from the Zvandiri programme which found improved adherence, retention, psychosocial well-being and viral suppression among adolescents engaged in Zvandiri compared with adolescents receiving standard care alone.
In addition, Zvandiri contributed further to the evidence review by leading a global consultation with adolescents living with HIV on behalf of WHO. 388 young people (10-24 years) from 45 countries were engaged in an online survey which was complemented by 20 Focus Group discussions across 10 countries. The survey provided data on whether adolescents living with HIV want psychosocial support (PSS) and at what point through the HIV cascade. The message was clear from young people – PSS is the catalyst that will transform the effectiveness of clinical care and achievement of viral suppression and living well with HIV. To share these findings, Zvandiri produced an animation for the guidelines committee and a second animation to provide feedback to all young people who participated in the consultation.
Zvandiri is now playing a lead role in supporting WHO to disseminate the guidelines through a series of webinars and country meetings, providing technical assistance to regional Governments and implementing partners as they adopt or adapt these guidelines.
Zvandiri’s programme and research data confirms young people and their caregivers face challenges in accessing appropriate information about viral load, affecting their adherence to Antiretroviral medicines and management of treatment failure. Information is commonly adult-oriented or not provided at all.
Zvandiri has produced a new set of resources to help children and adolescents understand viral load monitoring and the importance of achieving an undetectable viral load. Informed by programme and research data from Zvandiri and CeSHHAR, two animations (‘Not just a number’ and ‘Taking Charge of HIV’), two accompanying comics (‘Not just a number’ and ‘Taking Charge of HIV’), a set of activity cards and a discussion guide have been developed for use in health facilities, support groups and during home visits with children and adolescents on ART, as well as with their caregivers. This work was initially funded by UNICEF and the package is now being rolled out by Zvandiri in six USAID-supported districts.