Zimbabwe is heavily affected by the HIV epidemic, with 12.9% of its adults living with HIV. Despite significant economic challenges, HIV incidence has declined by 70% and AIDS-related mortality by 69% between 2010 and 2021. Zimbabwe has high coverage of HIV testing and treatment services and is on track to achieve HIV epidemic control. To reach this goal, the HIV response must expand to include underserved and marginalized groups and must successfully maintain persons receiving antiretroviral therapy (ART) in HIV care with viral suppression.
To address the priorities of the GH-23-0018 NOFO, Zim-TTECH (the Zimbabwe Technical Assistance, Training and Education Center for Health) is proposing activities that will help Zimbabwe reach and maintain HIV epidemic control. Zim-TTECH is a locally registered Zimbabwean organization that works with the Ministry of Health and Child Care (MoHCC) to implement comprehensive HIV clinical services at nearly 700 health facilities in five provinces. In this proposed work, Zim-TTECH will work with several partners - Zvandiri, who focuses on reaching children, adolescents and young people to link them to and maintain them in HIV care; Pangaea Zimbabwe AIDS Trust (PZAT), who works to capacitate staff at public health facilities to provide health services to key populations (KP) and pre- and post-exposure prophylaxis; Padare/Enkundleni Men’s Forum who will mobilize and engage men and boys to increase uptake of HIV services; Gays and Lesbians of Zimbabwe (GALZ), the Zimbabwe National Network of PLHIV (ZNNP+), and KP community based organizations (CBO) to reach and engage KP in care and address stigma; and the International Training and Education Center for Health (I-TECH) based at the University of Washington, which will provide technical assistance (TA) for data- and grants-management. These organizations, with extensive HIV experience in Zimbabwe, are uniquely positioned to rapidly expand comprehensive HIV services to the general and KP in Zimbabwe. The proposed work will promote sustainability by building capacity of the MoHCC staff by deploying staff to work alongside MoHCC staff and by providing TA.
The goal of the project is to help MoHCC achieve the UNAIDS 95/95/95 targets. This will be done by hiring, training, and deploying skilled and lay staff. These staff will help to expand access to comprehensive HIV prevention services and differentiated HIV care to all affected groups. HIV testing efforts will focus on underserved groups and populations at increased risk of HIV infection. Linkage to antiretroviral therapy (ART) will be maximized by streamlining clinic procedures and enhancing data systems to promote same-day ART initiation. Retention in ART and viral load (VL) suppression will be enhanced by promoting differentiated care models that are adapted to clients’ needs. Viral load testing coverage will be increased by promoting awareness among clients and clinic staff and by working to increase access to VL testing and to reduce turnaround time for results. Zim-TTECH will continue to expand its cervical cancer screening program by training staff and facilitating efficient referrals for treatment. To help MoHCC achieve its goal to eliminate HIV mother-to-child transmission, Zim-TTECH will ensure universal HIV testing of pregnant women, and for those with HIV, to ensure they receive ART, have VL suppression, and that their offspring receive testing for early-infant diagnosis and prophylaxis and treatment as appropriate.
Data use is a pillar of Zim-TTECH’s work, and program monitoring and reporting will be based on MoHCC data systems, with TA provided to improve data quality and use. In all of this work, Zim-TTECH will continue its close working relationship with MoHCC and will promote linkages with other national implementing partners so that program plans are aligned with national priorities and that they promote sustainability.
