(271) Improving Access to HIV-Related Healthcare, including Treatment and Pre-Exposure Prophylaxis (PrEP) in Zimbabwe Among Young Mothers Living with HIV

Background: HIV disproportionately impacts adolescent girls and young women living in Southern Africa. Rates of mother-to-child HIV transmission are also elevated in this group, highlighting the need for targeted interventions to improve the health of young mothers living with HIV. A non-profit organization in Zimbabwe, Zvandiri, founded a peer-led care model, the Young Mentor Mother (YMM) program, in response to this issue, to help improve rates of HIV treatment and PrEP use.

Objectives: To identify barriers and facilitators of a peer-led youth HIV healthcare initiative focused on improving HIV care among young mothers living with HIV in Zimbabwe.

Methods: We conducted semi-structured virtual interviews (N=29) among Zvandiri staff and YMM volunters to identify the benefits and challenges of the YMM program. We applied deductive and inductive thematic analyses to transcriptions and performed a qualitative analysis using Dedoose software.

Results: Participant narratives revealed several themes, including three vital benefits from the YMM program: 1) peer-support, 2) holistic care, and 3) women’s empowerment. Barriers to the success of the program identified from interviews mapped onto the social-ecological model, whereby structural factors (lack of funding, food insecurity), community-level factors (HIV-related stigma, socio-cultural differences in accepting HIV care), and interpersonal factors (intimate partner violence) were found to impact the implementation and scale-up of the program. Barriers to scaling-up the YMM program included limited funds, lack of resources, and cultural and geographic differences. We also identified socio-structural challenges to scale-up, such as intimate-partner violence, food insecurity, and HIV-related stigma.

Conclusions: The YMM program fills an important gap in HIV care for young women and girls and has several benefits, such as peer-support, holistic care, and women’s empowerment. Future research focused on the perspectives of clients, knowledge users, and young fathers will further inform the scaling of the program to new countries and regions.