KWIBUKA Jacques

How do you keep a 16-year-old on HIV treatment for life? Not with one more leaflet. With someone their own age who notices when they miss an appointment. This is how the CATS model works inside 12 Rwandan health facilities, with the numbers. Adapted from @zvandiri in 2019 and endorsed by @RBCRwanda for national scale-up.

When the @RwandaHealth looked at the health facilities with the lowest viral suppression among young people, it did something simple: it gave young people their own space. Youth corners are dedicated spaces inside health facilities where adolescents and young people can get HIV care without waiting in a queue of adults. Dream Village's peer supporters work in them. It's one example of how our model sits inside Rwanda's health system, not beside it: Community: 12 peer supporters, home visits and support groups System: we train health providers and teachers on youth-friendly HIV services National: member of the Technical Working Group on HIV Prevention, Care & Treatment; classified by @RBCRwanda under both Prevention and Care & Treatment; endorsed by RBC for national scale-up of the CATS model Youth-friendly services aren't a poster on the wall. They are space, time and someone who speaks your language. Health system leaders: what one change made your facility feel safer for adolescents?

Viral suppression tells you whether the medicine is working. It doesn't tell you whether a young person believes they deserve a future. That second question is what Wakakosha is for. The word is Shona for "I am worthy". It's a mental health and self-worth programme for young people living with HIV, developed in Zimbabwe by Beyond Stigma. All 12 of our peer supporters (CATS) have been trained on the Wakakosha curriculum by @zvandiri and Beyond Stigma. The programme is ready for Rwanda. What it needs now is funding to reach young people at scale. Why it matters: self-stigma can quietly undo good clinical care. A young person who feels less than others may miss appointments, withdraw from friends or stop planning ahead. We've seen the demand. In October at Bishenyi Market in Kamonyi, with @HDIRwanda and Sida, 164 people were screened for mental health against a target of 50, and 40 were referred for further care. Mental health isn't an add-on to HIV care. It is HIV care. Those working in youth mental health: what's the most effective low-cost way you've seen to tackle self-stigma?