Abstract
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.