CATS Driving ART Adherence In Children At Grassroots

COMMUNITY Adolescents Treatment Supporters (CATS) an Africaid, Zvandiri initiative which focuses on promoting  HIV prevention, treatment and care for children living with HIV, has broken societal barriers to prevention through initiating well planned treatment adherence and tracking systems.

By Michael Gwarisa in Mashonaland East

Speaking during a National AIDS Council (NAC) Media tour, Zvandiri Mentor, Tinashe Chigadza said the CATS program had proven to be a force to reckon in promoting HIV prevention, treatment and adherence to medication amongst young people in Mashonalnd East.

“My main role is to supervise CATS and assign them on different duties within the district. These guys are playing an important role at clinics in our district. They give counseling and encouragement to young people at various centers with the aim of promoting ART adherence.

“CATS are our first priorities before we go to beneficiaries. Whenever we talk about issues to do with adherence, we are guaranteed that the CATS can articulate to young people on issues regarding HIV. At times, adolescents find it difficult to accept their status. It’s a challenge at times to talk to someone who has not been disclosed to.

“Another big challenge CATS are having is that care givers are not forthcoming with regards to letting their children join our support groups. We see that although the issues of stigma and discrimination has been dealt with, stigma is  still highly entrenched in the caregivers,” said Chigadza.

According to national data,  children and particularly adolescents have fallen behind in terms of HIV response initiatives worldwide and even though HIV-related deaths are the decline in general, HIV related mortality has increased in the adolescent population.

According to the Ministry of Health and Child Care, in 2015, the estimated total number of people in need of ante retro viral treatment (ART) was estimated at 1,400,000 with 77, 000 being children (0-14 years) and 69, 000 adolescents (10-19 years). By the end of 2015, 61 percent of adults (above 15 years) living with HIV were on treatment and 80 percent of all children living with HIV were on ART.

However, through the CATS program, more young people have been initiated on ART even at grassroots level and more HIV prevention measures are being put in place.

Chipo Nhamburo (not real) a CATS in the Mwanza area in Mashonland East said the CATS initiative was  not just an grouping of young people living with HIV but a set up meant to give hope and support to adolescents living with HIV as well as encourage those who do not know their status to get tested.

“Most times, when adolescents discover they have HIV, they think it is the end of their lives. We have support groups here and we group them differently. Those from five to 10 years, we just teach on adherence and nothing regarding sex education but for those above the age of consent (16), we also teach on safe and correct use of condoms.

“Going into communities used to be a challenge as a result of serious stigma and discrimination, but as time went on we have seen more acceptance and we can now carry our programs freely. So far we are three CATS here, and each CATS registers children under his her name, once you have children under your name you ensure that you follow-up and you are always encouraging them to be adherent to their medication,” said Chipo.

Meanwhile, HIV remains one of the leading causes of mortality in children under five accounting for 21 percent of children deaths in Zimbabwe with most of these deaths among children and adolescents being as a result of failure or delayed identification of children and adolescents living with HIV, delayed initiation on ART, poor treatment adherence, and low retention in care.

NAC District Aids Coordinator for Marondera, Sabastian Manjengwa said they were doing targeted HIV programing in the area and other HIV hotspots and through the CATS initiative, the job had been made much easier.

“Marondera districts is one of the hotspots in Zimbabwe, and because of that we have a number of HIV prevention programs in the districts which also gives us a lot of partners who are coming to work with us. We have started by identifying our hotspots, we are very much aware of our hotspots because we are doing targeted interventions in the districts. We are doing programs which include service provision, which include VMC, testing among others. As we moved on with the program, we discovered that we have a number of young people living with HIV. Initially, we had some challenges because we did not know how to address them.

MR Manjengwa S, NAC, Marondera District AIDS coordinator

“We then discovered that a partner came to join us in the district, known as Africaid, Zvandiri. Zvandiri brought in some mentors who are responsible for handling young people. They brought in the CATS program, these are young people who are well trained to track their young ones on treatment adherence and offer them psycho-social supports,” he said.

The CATS program is funded by PEPFAR and USAID/Zimbabwe and the Zvandiri model is set to address HIV among children, adolescents and young people in 16 PEPFAR and 22 USAID priority districts.


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