HIV viral load suppression through collaboration

The Pongola municipality in South Africa, located in the Zululand district in the KwaZulu Natal province, has high rates of HIV-positive children (CALHIV). The statistics in this community mirror National statistics with low rates of access to ART and a large number of children remaining viral load unsuppressed. Studies have found that one out of every three children who are HIV positive have not achieved viral load suppression. The Government Capacity Building and Support (GCBS) program implemented by Pact in partnership with the Department of Social Development, the Department of Health, and PEPFAR-funded district support partners provide a multidisciplinary approach to support children to access treatment and become virally load suppressed. Working together, a team of social service and health practitioners were able to support Cebolihle, a young man aged 14 years, to achieve HIV viral load suppression.

Nonhlanhla, a community caregiver from Sinethemba Hope Organization, was made aware of Cebo by a field from Health Systems Trust (HST) while attending the Pongola fixed clinic partner meeting conducted monthly. A case conference was held between the clinic sister, HST field worker, and Sinethemba caregiver. It was reported that Cebo had not attended the clinic for the past 5 months. It was agreed that the community caregiver and field worker would conduct a home visit. Upon visiting Cebo, it was found that his mother had passed away 6 months prior. He was in the care of her brothers, aged 25 and 19 years. His brothers, not understanding the seriousness of his HIV status and the need for regular treatment, had not followed up or supported him to access the clinic for treatment. The fieldworker engaged the support of a GCBS social worker to provide adherence counselling to Cebo and to counsel his older brother on how best to support him, ensuring that he attended the clinic monthly. On Cebo's return to the clinic, he had blood tests which indicated that his viral load was exceedingly high, with 11 671 copies. The community care continued to visit the Cebo and his brothers, ensuring that he attended the clinic and took his ART. She also conducted a risk assessment to determine other support needs and developed a care plan which saw Cebo attending school regularly and accessing a child support grant. After 6 months of support, Cebo's latest viral load count indicated nineteen copies. He is now virally suppressed.

This is a true testament to how, through collaboration, practitioners at a community level, can support CALHIV towards becoming healthy, resilient adults.