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BACKGROUND: HIV-positive children with high viral load face multiple risks, including compromised immune systems, susceptibility to infections, and hindered growth and cognitive development, which affect their overall wellbeing. Addressing these challenges is crucial to promote the health and potential of children with living with HIV (CLHIV). The ACHIEVE project provides a comprehensive, household based CLHIV package to address barriers to ART uptake and ensure long term adherence and viral suppression in Tanzania.
METHODS: Between September and November 2023, the project added specialized food support to 14 CLHIV <18 with high viral load due to food insecurity, including one month emergency food support and engaging their caregivers in savings groups running income generating activities (IGAs) within food value chains. To ensure continuity of food support, the project provided capacity building on viable business along with seed capital to caregivers for their IGAs.
Data were collected at baseline and follow-up in terms of the core indicators assessed. Data analysis was conducted in Stata 17, examining the difference between baseline and follow-up statistics.
RESULTS: The outcomes demonstrated significant health and wellbeing improvements across multiple domains between baseline and follow-up. Monthly ART adherence rates soared by 54.6% from 43.8 to 98.4, contributing to improved health stability and a notable 78.5% reduction in viral load from an average of 67995 to 14628 copies. School attendance increased from an average of 2.9 to 4.5 days per week, accompanied by enhanced academic performance from an average of 26.2 to 40.8. The project successfully integrated 12 households into savings groups, initiating IGAs and substantially alleviating food insecurity. The caregivers’ average savings per week increased by 247% from TZS 4,923 to TZS 17,077, and their CLHIV gained an average of 5.2 kg of body weight: from 54.5 to 59.7kg.
CONCLUSIONS: This preliminary pilot demonstrated comprehensive success in addressing the diverse needs of CLHIV households. The combined approach of nutritional support, healthcare collaboration, and economic initiatives proved effective in improving HIV and wellbeing outcomes for food insecure CLHIV with a high viral load. Based on the findings, ACHIEVE intends to scale up the approach to all food insecure CLHIV and continue monitoring its effectiveness.