The Feasibility and Effectiveness of Teen Club Strategy for improving Antiretroviral Therapy Retention and Viral Load Suppression among Young People in Malawi Defence Force HIV Clinics

Abstract

Background

Despite the massive rollout of antiretroviral therapy(ART) , adolescents and young people  continue to experience  poorer treatment outcomes including viral load suppression. The study aimed to evaluate the impact of Teen Club strategy on treatment outcomes

Methods

We conducted  a mixed methods study in October 2023 at two military health facilities in Malawi. Teen Clubs were implemented in the two facilities one located in the southern region and the other in the northern region  of the country. A total of 38 participants including caregivers of adolescents and young people living with HIV (ALYHIV) and and healthcare workers(HCW) were purposely selected  for in depth interviews.  We also retrieved individual level  ART data  for ALYHIV from electronic medical record (EMR) before and after the establishment of Teen clubs at the selected facilities.  Chi-Square test was utilized  to compare  ART outcomes pre and post intervention while qualitative data were analyzed through thematic content analysis.

Results

Most HCWs supported supported the intervention , noting it provided a safe space for adolescents to access ART services and  pyschosocial support effectively. retention in care increased siginficantly from 82% to 93.5%(p<0.001) after implementing the strategy, and viral load suppression rose  to 92.7%(p=0.005)  compared to 82.1% before the intervention.

Conclusion

The teen club strategy  emerged  feasible and effective  in enhancing ART retention among young people at the two military HIV clinics. Future efforts should prioritse  overcoming structural barriers and integrating comprehensive support systems to maximize the potential of this intervention.