BACKGROUND: In 2020, Zimbabwe’s viral load suppression gap in children ages 0-17 was 28% compared to 10% in adults (Zimbabwe HIV estimates report, 2021). These gaps can be attributed to factors including difficulties in ART adherence among C/ALHIV stemming from challenges like complex treatment regimens, psychosocial barriers, and limited access to pediatric HIV care resources. In response, FACT Zimbabwe is implementing the PEPFAR/USAID funded OVC program in Manicaland and Masvingo provinces which supports C/ALHIV in achieving durable viral load suppression.
DESCRIPTION: During the period October to September 2023, 279 C/ALHIV with unsuppressed viral load (>1000 copies/mL) were identified, enrolled in the program, and received comprehensive OVC service package using a case management approach. The cohort was tracked for adherence to ART and viral load monitoring by a team of trained community health workers (CHWs) in collaboration with local health facilities. The CHWs conducted twice monthly ART adherence monitoring through home visits to facilitate children Enhanced Adherence Counselling (EAC) sessions, which were then reinforced through case conferences. A trend analysis was conducted at the end of the fiscal year to ascertain the changes, if any, in suppression rate of the cohort across the four quarters.
LESSONS LEARNED: The number of children with high viral load decreased by 84% during the period under review, with the most notable drop occurring within the first quarter and rates leveling out between the last two quarters. 75% (11F, 29 M) of the children with high VL at the end fiscal year were above 10 years.

CONCLUSIONS: Collaboration between local health facilities and community partners has been pivotal in enhancing viral load suppression CLHIV. In the upcoming phase, the project aims to refine and tailor VLS support, focusing on addressing the specific viral load challenges encountered by adolescents 10-17 years, who are struggling to achieve viral load suppression.