In Kenya, the HIV epidemic among adolescents and young people between the ages of 10 and 24 is characterized by relatively high HIV incidence and sub-optimal treatment outcomes, including a high loss to follow-up, low adherence to treatment and low viral suppression. MHRP and local partners initiated Operation Triple Zero (OTZ) in its Kisumu West program, with the goal to have zero missed clinic visits, zero missed pills/medications, and zero viral load.
Weekend clinic hours were established to help adolescents keep up with appointment visits, as previous weekday hours conflicted with the school day. These clinic hours have led to increased attendance, thereby significantly improving retention, viral load monitoring and timely dose adjustment and ART optimization among this age group.
The Kisumu West program has also enrolled more than 540 adolescents into OTZ clubs, where adolescents receive peer support and share best practices for adhering to treatment.
“OTZ clubs have instilled positive behavior change among our adolescents as they get opportunity to interact with one another and with health worker mentors in a constructive way,” said Christine Magak, pediatric lead for the program. “This has greatly enhanced their adherence habits, reduced stigma and improved their performance in school.”
These activities are improving treatment outcomes among this age group. In a recent quarter, 60% of participants who began with high viral loads achieved re-suppression.
“Before I joined OTZ, I constantly had high viral load and, at one point, had lost hope in life,” said one participant named Rachel. “I made a commitment never to miss my medication... Today, I am virally suppressed and able to educate my fellow youths on the importance of good adherence for improved quality of life.”
Operation Triple Zero is an initiative of the President’s Emergency Plan for AIDS Relief (PEPFAR). MHRP has implemented PEPFAR in Kenya since 2004.