In Zimbabwe, it is estimated that only three out of four people living with HIV know their status. Past efforts to reach the untested have been unsuccessful, so a new approach is needed.
The Zimbabwe HIV Care and Treatment (ZHCT) project is a five-year, multisectoral effort that complements the work of the Government of Zimbabwe to strengthen community-level HIV care and treatment services. The project supports Zimbabwe’s attainment of the 90-90-90 goals for HIV epidemic control set forth by the Joint United Nations Programme on HIV and AIDS (UNAIDS), particularly the first and third targets, which focus on knowledge of HIV status and viral load suppression. FHI 360 and sub-awardee Plan International are implementing the project in close collaboration with the Ministry of Health and Child Care, the National AIDS Council and other stakeholders. ZHCT is funded by the U.S. Agency for International Development (USAID).
The project has two specific objectives:
- Increase the availability of high-quality, comprehensive care and treatment services for people living with HIV, through community-based, home-based, index case testing that links to HIV and tuberculosis screening and referral for care
- Strengthen community-level health systems to monitor, track and retain persons living with HIV who are in care, identifying and tracking in particular those who stop antiretroviral treatment and supporting their adherence to treatment with community antiretroviral refill groups
FHI 360 combines two HIV testing strategies, which have achieved, as of 2017, a five-fold increase in the number of people identified as having HIV. First, health workers use a home-based index case approach, going directly to the households of individuals who have tested positive for HIV and testing their sexual partners and children. Next, health workers use a sexual network notification approach, identifying individuals’ past sexual partners. Because the health workers are able to build trust with those they test, they can successfully obtain the names and addresses of other partners and are then able to test them.