FRAB0301 | VIRAL LOAD MONITORING AMONG ADOLESCENTS LIVING WITH HIV: A CASE OF ADOLESCENT TRIPLE ZERO MODEL JANUARY–DECEMBER 2023, ZIMBABWE

Media Matirongo¹, Mxolisi Ngwenya¹, Alex Ingwani¹, Chidzewere Nzou¹, Ottilia Makoto¹, Wedzerai Chikari¹, Silvanos Chigwedere¹, Rickie Malab², V.T.S Chitimbire¹, Cham Haddi Jatou², Chiedza Mupanguuri³, Getrude Ncube³ | ¹Zimbabwe Association of Church Related Hospitals, Harare, Zimbabwe; ²Division of Global HIV and TB, U.S. Centres for Disease Control and Prevention, Harare, Zimbabwe; ³Ministry of Health and Childcare, Harare, Zimbabwe

Zimbabwe has achieved the 95-95-95 HIV goals for adults, while the first and third 95 goals for children are falling short. The Zimbabwe Association of Church-Related Hospitals implemented the Adolescents Triple Zero (ATZ) model at 28 healthcare facilities. This initiative aims to improve treatment outcomes for adolescents living with HIV (ALHIV) aged 10–24 years who are receiving antiretroviral therapy (ART). Between January and March 2022, facilities implementing ATZ achieved a viral load (VL) coverage of 46% for ALHIV aged 10-24 years, and 86% had low-level viremia (LLV). The ATZ project was implemented in 28 facilities in four provinces from January to December 2023. The model recruited 35 ATZ Champions aged >18 years who are living with HIV and committed to assisting their peers achieve three zeros: “zero missed drugs," “zero missed appointments," and “zero viral load." To ensure effective implementation, the Ministry of Health and Child Welfare and the ZACH technical team provided training and on-site mentorship to ATZ champions. Routine program data from January to December 2023 from 28 facilities was analyzed to review trends in undetectable VL, LLV (1-1000 c/mL), unsuppressed VL (VL above 1000 c/mL) and coverage (proportion of valid VL/on ART) among ALHIV in the ATZ program. By December 2023, more follow-up and monitoring of ALHIV led to a rise in VL coverage from 93% to 96%. During the review period, 99% adherence was reported among ALHIV enrolled in the ATZ model. Peer support from ATZ champions also helped raise the percentage of undetectable VL from 79% to 89%. The percentage of ALHIV with unsuppressed VL decreased from 6% to 2%, and the proportion of ALHIV with LLV decreased from 15% to 9%. The ATZ champions model has improved support for adherence and treatment outcomes for ALHIV at implementing facilities. The notable reduction in unsuppressed VL and improved proportion with undetectable VL is suggestive that the ATZ model could be used to close gaps in VL monitoring and suppression among ALHIVs. A comparative study for ATZ supported and non-supported facilities could provide additional information on the effectiveness of the model.