Background: Globally almost 60 percent of new HIV infections among 15-24 year olds are in adolescent girls/young women (AGYW), who face parallel risks of pregnancy and HIV. Data suggests mothers who received structured support from trained, supervised mentors were more likely to remain in care at 6-months postpartum compared with women receiving standard of care.
Description: The AIDSFree Program (June 2017-December 2019) aims to improve HIV and other health/social outcomes for both HIV-positive and HIV-negative pregnant adolescents (10-19), young mothers and their children. The program uses a case management approach comprised of a Home Visiting Team (HVT): peer-led mentoring for the pregnant AGYW/mother, support for parents/caregivers to address structural barriers to care, decrease stigma, and mobilize support (with male/female teams to reach men); and supervisory support for ongoing quality assurance. Through home-visits, HVTs support access to and retention in ante-natal care, including prevention of mother-to-child transmission (PMTCT) services and post-partum services for the mother-baby pair. Building resilience and problem-solving ability are key components as well as ensuring a strong bi-directional referral network to health/social services. Training for mentors and supervision of the HVT are important to overall success of the program.
Lessons learned: The project is implemented through two community-based organizations in Kisumu and Homa Bay counties, and will expand to Nairobi in 2018. The AIDSFree project completed a literature review in November 2017 and developed a comprehensive training curriculum specific to AGYW. Training covers topics including antiretroviral adherence and viral suppression; pre-exposure prophylaxis; partner disclosure; screening/referring for post-partum depression; and addressing gender-based violence. Training materials include standard operating procedures, job aids, and monitoring/evaluation tools. In January 2018, AIDSFree trained 24 HVT cadres (Mentors, Household Facilitators and Supervisors, total of 80 participants) on the 10-day training package including supplemental supervisor training. Community engagement sessions facilitate the commitment and support of community leaders. The project aims to reach 192 adolescents and their children.
Conclusions/Next steps: To reduce the gap of lack of services and programs designed for pregnant adolescents, young mothers and their children in Kenya and globally, program results will be shared with county and national governments and PEPFAR to assist with policy formulation and design.

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