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![Page 1: Ensuring Adherence and Retention to HIV Care and Treatment among Orphans and Vulnerable Children A Multi-Country Experience Thebisa Chaava MPH Senior Technical.](https://reader036.fdocuments.us/reader036/viewer/2022070413/5697bfa71a28abf838c98c7c/html5/thumbnails/1.jpg)
Ensuring Adherence and Retention to HIV Care and Treatment among Orphans and
Vulnerable ChildrenA Multi-Country Experience
Thebisa Chaava MPHSenior Technical Officer, Community
Engagement and Mobilization
![Page 2: Ensuring Adherence and Retention to HIV Care and Treatment among Orphans and Vulnerable Children A Multi-Country Experience Thebisa Chaava MPH Senior Technical.](https://reader036.fdocuments.us/reader036/viewer/2022070413/5697bfa71a28abf838c98c7c/html5/thumbnails/2.jpg)
EGPAF : Background
• The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) is a nonprofit organization
• Dedicated to preventing pediatric HIV infection and eliminating pediatric AIDS through research, advocacy, and prevention, care, and treatment programs.
• Founded in 1988, supports 7,000 sites in 14 countries with a particular focus in Africa.
• EGPAF supports health facilities and local organizations to provide clinical and psychosocial support(PSS) for HIV-positive and -exposed children, as well as OVC; through Integration of PSS into clinical and community-based care and support services.
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EGPAF OVC Interventions
EGPAF country programs use one or a combination of the following child-centered approaches for the identification of OVC, testing and enrollment and retention in care:
1. Community counselor home visits/door-to-door screenings.
2. Community OVC and HIV testing campaigns.
3. Community-based psychosocial support groups.
4. Facility-based PSS groups for children
5. Facility PSS groups for children and their families.
6. Ariel Clubs for HIV-positive children.
7. OVC Caregiver training and socioeconomic support
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Ariel Clubs and OVC access to testing, treatment and retention in care
In 12 countries, EGPAF uses Ariel Clubs to link vulnerable children to HIV counseling and testing (HTC) , treatment, and follow-up for retention in care by: • Facilitating disclosure of HIV-positive
status by parents/caregivers to their children.
• Helping children understand and accept their HIV positive status and how to live their life positively.
• Building peer support for HIV-infected and affected children.
• Linking children and their parents/caregivers to other support services, such as home care services, food support, income-generating activities, and legal services through resource mapping.
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Ariel Clubs: Key Programming Elements
• Age-specific activities.
• For children living with HIV.
• Health facility-based.
• Peer /caregiver facilitated and supported by health care workers.
• Focus on disclosure and ART adherence.
• Align with school programs for collection of ART collection and clinic visits.
• Ariel camps during school holidays.
![Page 6: Ensuring Adherence and Retention to HIV Care and Treatment among Orphans and Vulnerable Children A Multi-Country Experience Thebisa Chaava MPH Senior Technical.](https://reader036.fdocuments.us/reader036/viewer/2022070413/5697bfa71a28abf838c98c7c/html5/thumbnails/6.jpg)
Project KeneyaEGPAF-Côte d’Ivoire
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Project Keneya: Background
• Funded by PEPFAR through CDC, Project Keneya’s OVC model and interventions have proven effective in increasing testing, treatment, and adherence among children and youth.
• Developed initiatives to promote HCT for OVC and enrollment of infected children into care.
• Uses both facility- and community-based approaches to identify OVC
• Community counsellors screen OVC during home visits, provide nutritional and economic well-being support and refer OVC to health facilities.
• OVC who test positive are enrolled in care and OVC community-based PSS groups.
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Project Keneya: HIV Testing Approach among OVC
• Brings HIV testing to beneficiaries/close to habitation.
• Generates excitement for parents/OVC guardians for HIV testing through campaigns held in their communities.
• Campaigns done in collaboration with community voluntary counseling and testing (VCT) centers or health facilities.
• Systematically counseling of OVC parent/caregiver on HIV test by community counselors.
• Provides family pre-test counseling, HIV test, and post-test counseling
• Accompanying of infected children and parent by community counselors to health facilities for enrollment into pediatric care.
![Page 9: Ensuring Adherence and Retention to HIV Care and Treatment among Orphans and Vulnerable Children A Multi-Country Experience Thebisa Chaava MPH Senior Technical.](https://reader036.fdocuments.us/reader036/viewer/2022070413/5697bfa71a28abf838c98c7c/html5/thumbnails/9.jpg)
Project Keneya: Adherence and Retention in Care
• Tutorship and peer support group for HIV positive OVC
• Monthly peer support group of 10-12 children to discuss adherence to treatment, self esteem, their future, etc.
• Non-adherent children are visited by tutor (adherent adolescent or older children) to supervise drug taking and provide peer counseling.
• Nutritional support and counselling
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Project Keneya: Results to Date
From October 2014 to June 2015:
• 20,832 OVC were served.
• 13,929 children know their HIV status.
• 4,488 children were tested and 75 (2%) were positive.
• All 75 children referred to health facilities and enrolled in pediatric care.
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Project UmojaEGPAF-Kenya
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Project Umoja: EGPAF-Keneya’s OVC Model
Funded by PEPFAR through CDC, Project Umoja uses a multi-pronged approach to support HIV testing and counseling, uptake, and linkages to care • Girls ART group therapy sessions
to address social and academic challenges hindering school completion.
• Caregiver monthly meetings.• Food distributions. • Caregiver trainings.• Evidence-informed behavioral
interventions (EBI) classes for OVC.
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Project Umoja: Key Components
EBI Classes for OVC• Healthy Choices for a Better Future:
54 Boys and 58 Girls enrolled.• Healthy Choices II: 18 Boys and 14
Girls enrolled.
PSS Sessions Targeting Girls• 173 girls provided with group
therapy sessions to address social and academic challenges.
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Project Umoja: Results of EGPAF-Kenya Model
OVCs supporte
d
Known statu
s
Total
Positive
s0
1,000
2,000
3,000
4,000
5,000
6,000
2414 2406
50
2468
2462
68
4,882 4,868
118
HTC Uptake
M F Total
M
F
Total
0% 20% 40% 60% 80% 100% 120%
On CARE; 92%
On CARE; 97%
On CARE; 95%
Currently on ART; 58%
Currently on ART; 71%
Currently on ART; 65%
Linkage to Care and ART
OVC = 4,882; TARGET = 5,000
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• OVC platform is effective for increasing testing , ART adherence and retention
• Multi-pronged comprehensive programs addressing multiple access and retention needs of OVC (community campaigns, door-to-door screening, accompaniment to health facility, and ongoing PSS group)
• OVC and caregiver accompaniment to health facility by community.
• Care givers and OVC needs trainings and ongoing PSS for motivation to test, treat and remain in care.
• Within support groups sessions should be issue based and age specific.
Conclusion and Lessons learned
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Merci, Asante Sana, Thank You