SUAB0302 | STRENGTHENING BONDS: THE IMPACT OF THE BUDDY SYSTEM ON VIRAL SUPPRESSION IN CHILDREN AND YOUTH LIVING WITH HIV IN MPILO, ZIMBABWE

Primrose Sethule Dube¹, Sinatra Nyathi¹, Freeman Dube¹, Takura Matare², Douglas Moyo¹, Amon Mpofu¹, Bernard Madzima¹ | ¹National AIDS Council of Zimbabwe, Bulawayo, Zimbabwe; ²Ministry of Health and Child Care, Harare, Zimbabwe

Records review at Mpilo Centre of Excellence revealed poor antiretroviral therapy (ART) outcomes and low viral load suppression (VLS) among children and young people living with HIV (CYPLHIV) aged 15 to 24 in 2021. Significant challenges included high rates of defaulting, loss of follow-up, and low return rates for care. To address these issues, the Ministry of Health and Child Care, the National AIDS Council, AHF Zimbabwe, and the Million Memory Project Zimbabwe (MMPZ) launched a peer-led intervention, the Buddy System, from 2022 to 2023. This program aimed to help young people living with HIV get better treatment results and achieve viral load suppression by using a community-based approach that involved training peers, creating support groups, providing youth-friendly spaces, offering health education, reaching out to the community, and tracking MMPZ-implemented activities guided by the ecological model to empower youth with essential information and skills in a supportive environment. Peer educators between the ages of 17 and 24 were trained to teach and help others, which made it easier for people to get sexual and reproductive health services and take their medications as prescribed. Follow-up efforts for defaulters aged 0 to 24 included home visits to reconnect clients who had disengaged from care. Those who returned to the clinic were paired with a buddy and participated in additional interventions to ensure their retention in care. This comprehensive strategy aimed to address gaps in ART coverage and improve health outcomes for children and adolescents living with HIV. The peer-led interventions were effective and youth-friendly at the Mpilo Centre of Excellence, where they helped CYPLHIV get better treatment and lower their viral load. Retention in care significantly improved, with the proportion of active patients rising from 89% (2,653) in 2021 to 97% (3,304) in 2023 (χ² = 170.9, p = 0.00). During the same time period, viral load suppression also went up, from 83% (1,925) to 88% (2,529) (χ² = 22.0, p = 0.00). Participants reported feeling more motivated to adhere to their medication, attend appointments, disclose their status, and adopt healthier lifestyles. Peer supporters were instrumental in providing emotional support, encouraging medication adherence, and combating stigma. It is recommended to scale up peer-led interventions to additional health facilities across Zimbabwe.