BACKGROUND: Although South Africa has made progress towards achievement of the 95-95-95 targets in the overall population, a notable gap in HIV testing and treatment of children and adolescents remains.
Within the public sector, HIV treatment services are provided through approximately 3 500 primary health care clinics and community health centres. In order to reach the 95-95-95 targets, minimum standards of care for children living with HIV (CLHIV) need to be explicitly defined, prioritized, communicated and implemented at scale in all health facilities, and monitored across facility, district and provincial levels.
DESCRIPTION: Consultations were held with national and provincial officials, partner organizations and clinicians aimed at identifying key interventions to improve case finding and treatment of CLHIV. The output of the consultation was the Paediatric and Adolescent HIV Matrix of Interventions (MOI) that is aligned to the 95-95-95 strategy (Table 1). Detailed standard operating procedures (SOPs) outlining how each intervention should be implemented and monitored have also been developed.

Table 1: The Paediatric and Adolescent HIV Matrix of Interventions

LESSONS LEARNED: The MOI has assisted in focusing, standardising and co-ordinating interventions implemented by multiple stakeholders. To date improvements against the 95-95-95 targets remain modest, in part as a result of the COVID-19 pandemic. Although key interventions should be implemented across all facilities, some interventions have proved difficult to implement without additional support and resources provided by partner organizations.
CONCLUSIONS: The MOI provides a standardised framework for implementing evidence-based, proven strategies focused on identification, strong linkage systems, and improved retention and viral suppression. It provides the basis for ensuring standardized implementation and for holding health facilities and partner support organisations accountable for ensuring improved outcomes for children living with HIV.

Download the e-Poster (PDF)