AIDS 2024 Abstract: 10160

Title: Impact of Case Management on Children Living with HIV Under Chibefwe Catchment Area in Zambia
Authors: B. Ng’andu, C. Mukelabai, C. Mizinga, P. Musamba
Category: D2: Social and Behavioral Aspects and Approaches to HIV and Living with HIV
Country of Research: Zambia

Background

Project Concern Zambia (PCZ), through the USAID Empowered Children and Adolescent Program (ECAP) II, has been implementing the Orphans and Vulnerable Children (OVC) Case Management Program to support government efforts in achieving the UNAIDS 95-95-95 goals. This initiative aims to contribute to HIV epidemic control by promoting HIV case finding and providing household-based treatment and care support. Since 2020, USAID ECAP II has implemented case management in the Chibefwe catchment area in Mkushi through Community Case Workers (CCWs).

Description

The program employs a community case management approach to ensure prompt initiation of antiretroviral therapy (ART) for individuals testing HIV-positive through community HIV testing services (HTS). Additionally, the program traces and re-engages clients experiencing treatment interruption (ITT).

Monthly home visits are conducted for households with children and adolescents living with HIV (C/ALHIV), focusing on adherence support. Community Case Workers utilize screening tools to identify adherence challenges and deliver personalized services, including referrals to health facilities when necessary. To streamline care, the program collaborates with health facility personnel to collect viral load (VL) samples directly from clients’ homes, ensuring a comprehensive and person-centered approach to care.

Lessons Learned

The community-based case management approach has significantly improved HIV/AIDS services in the Chibefwe area. Since the program’s launch:

• The number of C/ALHIV on ART increased from 179 in 2020 to 223 in 2024.
• Viral load suppression improved dramatically, rising from 67% to 99%.
• The number of virally unsuppressed C/ALHIV dropped from 29 to 3 over the three-year period.

Community Case Workers played a critical role in achieving these milestones by tracing clients who were not on treatment, addressing treatment interruptions, and supporting newly diagnosed individuals in accessing care. The program’s focus on person-centered services reduced treatment delays, minimized disruptions, and alleviated long queues and waiting times at health facilities.

Conclusion and Next Steps

Project Concern Zambia’s community-led approach, implemented under USAID’s ECAP II program, has made significant contributions toward achieving the UNAIDS 95-95-95 goals. The program’s collaborative model—highlighted by home-based viral load sample collection and intensive adherence support—demonstrates the efficacy of community-based initiatives in improving healthcare outcomes.

Moving forward, sustaining and scaling up this approach could ensure continued improvements in ART enrollment and viral suppression rates, thereby advancing the fight against HIV in Zambia.

Additional Notes

• Ethical Research Declaration: This abstract is based on program implementation activities and does not involve human subjects research.
• IAS Affirmations: The abstract was submitted with the authors’ consent and in compliance with IAS policies, including the embargo policy.

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