Re-Engage Adolescents and Children with HIV (REACH)
REACH is facility situated peer support model that aims to improve HIV treatment and care services and treatment outcomes for adolescents living with HIV. REACH sets out to demonstrate an innovative approach of harnessing the lived expertise of A/YPLHIV (18-24yrs) as lay community health workers who are integrated into health facilities as Peer Supporters to improve treatment and care services amongst their adolescent peers (10 – 19 years). The model also places emphasis on providing the Peer Supporter with skills, capacity-building and opportunity to improve their own health and wellbeing.
REACH is implemented in 20 facilities across six countries (Ethiopia, Zambia, Uganda, Malawi, Kenya and Cameroon) and engages 40 Peer Supporters.
AIDS is now the leading cause of death among adolescents and young people (10-19) in Africa and the second cause of death among adolescents globally. It is becoming increasingly apparent that adolescents are underserved by existing HIV services, with significantly worse access to ART than adults, with lower rates of adherence, virological suppression, and immunological recovery.
Even when access to treatment and adherence support is in place, complex social issues such as stigma, psychological distress and fear, family conflict and caregiver challenges contribute negatively to the health of HIV-positive children and adolescents. This is further compounded by unfriendly health services, disempowering sexual reproductive health (SRH) legislation and inaccurate perceptions of HIV-related risk.
Improved adolescent-friendly health services (AFHS) and adolescent-orientation with increased service engagement and retention in care• Peer Supporters (YPLHIV) are integrated into health facilities to deliver peer-led AFHS
• Health providers are exposed and sensitized to adolescent needs and priorities
Strengthened peer support capacity and resilience• School-leaving YPLHIV are provided an opportunity to gain work experience, learn new skills and receive psychosocial support
• Peer Supporters earn a stipend, and are provided a detailed job description, are closely supervised, appraised and integrated within the facility
• Peer Supporters are locally trained on treatment literacy, disclosure, adherence and psychosocial support
• Peer Supporters are provided practical support to link with YPLHIV country networks
Shared evidence for a facility-based peer support model• Document implementation considerations and best practices for effective integration of peer supporters into each health facility
• Introduce and establish differentiated psychosocial support groups and adolescent friendly activities
• Monitor shifts in retention in care rates alongside the provision of peer support