Adolescents and young people account for an estimated 45% of all new HIV infections, of which 70% live in sub-Saharan Africa. Within this age group, young women and key populations are disproportionately affected. Despite having the necessary tools, diagnostics and treatment, only half the number of adolescents who require antiretroviral therapy are accessing this life-saving treatment. Adolescents and young people continue to be underserved and left behind, and as a result are experiencing higher rates of new HIV infections, poor virologic suppression and AIDS-related deaths. As we fail to reach the 2020 super-fast-track targets by a substantial margin, intensified focus on linking adolescents and young people to services is urgently needed.
Amplifying best practices and evidence-driven solutions in finding, treating and retaining adolescents and young people will require service delivery mechanisms that can move beyond a siloed biomedical response to ones that address the underlying psychosocial barriers and intersecting forms of discrimination, stigma and structural inequality affecting their lives. A holistic, integrated approach is needed, one that listens, understands, and responds to their needs, whilst putting young people and their communities at the centre of that response.
We need to invest and strengthen the capacity of communities to become an integral part of the health service through developing and promoting innovative, high quality, user-responsive models of care that effectively link and support facility and community organisations in a continuum of excellence. This toolkit provides much-needed support to that linkage, offering several strategies and case examples across the treatment cascade on how clinics and local organisations are working together, whilst outlining a clear plan for collaboration that may be taken up across the region.
The development of these toolkits is based on a partnership between ViiV Healthcare’s Positive Action and PATA, that was initiated in 2016. The partnership focused on clinic-community collaboration, working across nine countries, whilst supporting and drawing lessons from 36 of such clinic-community collaborative partnerships. This led to the development of the first edition of the Clinic-Community Collaboration (C3) Toolkit ‘Working together to improve PMTCT and paediatric HIV treatment, care and support’ and the ‘Be-Connected Course’ in 2017. This second edition of the C3 Toolkit once again offers a practical “how to” application of the methodology that is centred on cooperation, joint planning and structured partnership, with the focus now on how clinics and communities can work together to improve service delivery for adolescents and young people. This edition of the tool has been informed though drawing lessons from 20 clinic-community collaborations across Zambia and Kenya.
We are honoured to continue the scale up of clinic-community initiatives, while furthering the evidence on their value, with such evidence used to advocate for investment, resource allocation and capacity building. Today more than ever, clinic community collaboration is needed to ensure that HIV service delivery remains a priority, human rights are respected, protected and fulfilled, and policymakers and implementers are held accountable to working collaboratively at all levels.