PurposeTo address gaps in progress in coverage of HIV diagnosis and treatment services for children and adolescents living with HIV compared to adults, the Faith-Based Action for Scaling Up Testing and Treatment for Epidemic Response (FASTER) initiative facilitated partnerships between government, civil society organizations, private sector, and faith-based organizations. FASTER addressed structural barriers to pediatric and adolescent HIV testing and treatment services, expanded access to innovative drugs and diagnostics, and scaled up evidence-based interventions across four countries (Nigeria, Tanzania, Uganda, and Zambia). The purpose of this analysis is to describe progress towards the six FASTER priority actions and to identify persistent programmatic gaps for targeted interventions and ongoing quality improvement efforts.MethodsAggregate data on seventeen FASTER performance indicators and routine monitoring, evaluation, and reporting indicators from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) were compared between baseline and endline of the initiative across 245 FASTER priority facilities.Major findingsMeasurable progress was observed across all indicators. Key successes included expansion of registration of priority pediatric diagnostics across all countries, and an increase in the proportion of children receiving multi-month dispensing, from 64% to 73%. Areas with ongoing service gaps were identified. For instance, fewer than half of facilities reported achieving rates of ≥90% completion of family trees for index testing in children or post-breastfeeding HIV testing for infants.ConclusionThis assessment at health facilities implementing the FASTER initiative demonstrated progress towards improving HIV services for children and adolescents. It also identified opportunities for continued improvement to address ongoing gaps. Lessons learned from the FASTER initiative can inform national strategies to rapidly advance progress to improve services for children, adolescents.
Keywords: HIV; Nigeria; Tanzania; Uganda; Zambia; adolescent; children; faith-based.
Results from the Assessment of the Faith-Based Action for Scaling-Up Testing and Treatment for Epidemic Response (FASTER) Initiative: Strengthening Pediatric and Adolescent HIV Services in Tanzania, Nigeria, Zambia, and Uganda, 2020-2022Why was this done?Children and adolescents living with HIV have lower rates of diagnosis and treatment than adults. The FASTER initiative was created to close this gap by improving HIV testing and treatment services for children and adolescents.What did we do?FASTER brought together governments, civil society groups, the private sector, and faith-based organizations in Nigeria, Tanzania, Uganda, and Zambia. These partnerships worked to overcome barriers to care, make new medicines and diagnostic tools more available, and scale up proven approaches to strengthen HIV programs for children and adolescents. We reviewed data from health facilities participating in this initiative on HIV testing and treatment in children and adolescents before and after the initiative.What did we find?Data showed progress in HIV testing and treatment for children at participating health facilities. However, challenges remain in areas such as testing children of people living with HIV, ensuring children stay on treatment, and tracking infants of mothers living with HIV.Why it matters:The lessons from FASTER show that partnerships with faith-based organizations may help strengthen HIV services for children and adolescents. These experiences may help guide other programs working to improve HIV care for these populations.