HIV POSITIVE YOUTH: LINKAGE & RETENTION IN CARE

HIV POSITIVE YOUTH: LINKAGE & RETENTION IN CARE

Site C Youth clinic HIV care pathway DAY 1 Test HIV + PIMA point of care CD4 count in in 3-5 days initiation + in session 3 session 4 1 month Youth Club

Site C Youth clinic HIV care pathway DAY 1 Test HIV + PIMA point of care CD4 count in in 3-7 days initiation + in session 3 session 4 1 month Youth Club

PIMA point-of-care CD4 Introduced same-day CD4 testing in 011 A before-after observational study was conducted a year : 90% left the clinic knowing their eligibility Reduced time to initiation by 6 days.

100% 90% 80% 70% 60% 50% 40% 30% 0% 10% 0% 33% 31% 9% 3% 4% 40% 44% 6% 67% 11% 46% 43% 8% 33% 8% 56% 56% 9% 4% 17% % 1% 3% 5% 5% 6% 0% 0% 0% 6% 8% 0% 0% 5% 8% 11% 13% 0% 7% 0% 0% 0% Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 CD <100 CD 100-00 CD4 00-350 CD4 350-499 CD4>500 Youth: PIMA

Site C Youth clinic HIV care pathway DAY 1 Test HIV + PIMA point of care CD4 count in in 3-7 days initiation + in session 3 session 4 ONGOING Youth Club

Fast track initiation & model Implemented in 013 initiation fast-tracked from average of 8 days to 1 week Adherence plan to address common adherence barriers

SESSION OBJECTIVE CONTENT

& initiation 300 60% 50 50% 00 40% 150 30% 100 0% 50 10% 0 010 011 01 013 014 # # Initiated % LTF ** 014 data does not include Q4 014 0%

Site C Youth clinic HIV care pathway DAY 1 Test HIV + PIMA point of care CD4 count in in 3-7 days initiation + in session 3 session 4 ONGOING Youth Club

In Option of attending 1 or sessions that cover: acceptance of HIV status HIV education disclosure & support options caring for themselves & potential sexual partners importance of repeat CD4 at 6 months Invited to join a Youth Club

Site C Youth clinic HIV care pathway DAY 1 Test HIV + PIMA point of care CD4 count in in 3-7 days initiation + in session 3 session 4 ONGOING Youth Club

Youth Clubs Closing HIV cascade gaps in the long-term care of HIV+ youth Group of 0 horizontally infected youth Mixed group of non-, newly initiated on & stable on Meet monthly for first year, thereafter once every months Integrated clinical care & psychosocial support

Youth Clubs Counsellorsrecruit in & newly initiated youth during sessions Nurses recruit stable youth Virtual mentor programme Waiting room talks Each club has own club facilitator (MSF) & own club PN (City)

Club facilitator records weight & symptom in paper register 45-60min interactive, youth-specific discussion New on receive pre-packed from club PN after discussion Stable receive pre-packed from club facilitator in club room FP, blood and clinical visit with club PN directly after discussion

Youth Clubs 304 ever enrolled Age out at 5 years, moved as a group to form own adult club Current 168 youth across 10 youth clubs at SCY 3/10 youth clubs are for school-going youth youth clubs at non-youth specific clinic, 1 for vertically infected adolescents

100% Youth Club Cohort 90% 80% 70% 60% 50% 40% 30% 0% 10% 100% 97% 95% 9% 0% TOTAL 3 month RIC TOTAL 6 month RIC TOTAL 9 month RIC TOTAL 1 month RIC

HIV cascade closing the gaps Test HIV+ eligibility initiation 6mts RIC Long term RIC PIMA Fast track initiation & In Youth Club Adult Club