Enhancing Linkages To At Risk Adolescents – A Home Visiting Team Model (HVT) For Pregnant and Breast-Feeding Adolescents

Home visiting models have widely been used globally whereby community cadre teams offer households with health, social and referral services. However, few to none have been designed to specifically reach pregnant adolescent girls (both HIV-positive and HIV-negative adolescents) The pregnant adolescent girls and young women represent a highly vulnerable group with respect to HIV incidence, HIV testing coverage, HIV-related mortality and mother to child transmission (MTCT) of HIV. A number of studies in the Sub-Saharan Africa has reported that young women compared to older women, are less aware of their HIV status, have lower antiretroviral (ARV) uptake, higher loss to follow up from PMTCT programs, reduced uptake of early infant diagnosis and increased MTCT of HIV. There are many social stigmas involved with the adolescents, as they go through harsh environments in schools and in the community. HIV and AIDS in school is not only viewed as a killer disease but also as a sign of sexual immortality. Many adolescents feel afraid to disclose their status, due to the stigma that is behind it. Fear is also found in walking into health centers and asking about HIV/AIDS, due to the conception that health workers will subjectively look down on them and their condition.

The model engages 2 Household Facilitators (HF), one female and one male largely pulled from existing Community Health Volunteer (CHV) cadres (age ~31-45) and Mentors who are females, resident in the community and themselves mothers. Mentors should be sensitive to the issues of pregnant adolescents, adolescent mothers and their infants (Age ~19-30). They should have training as CHV, peer educators or related HIV/ASRH issues.

The model realized an improved female adolescent maternal and newborn HIV and related health outcomes (including improved cognitive outcomes among infants) and zero HIV incidence among adolescent at-risk females