Children and adolescents living with HIV (C/ALHIV) in Mozambique were being served by both facility-based health services and community-based supportive services, but there was little collaboration between them.

A joint data review between the projects supporting the 2 services identified discrepancies between their records, with missing or incorrect data on indicators, such as numbers of C/ALHIV on treatment and viral load (VL) testing status.

A Data to Care (D2C) intervention was piloted in which staff from both facility-based and community-based projects conducted routine joint data reviews to correct and complete their data to improve care for C/ALHIV and guide actions for health care providers to reengage C/ALHIV or provide additional services as needed.

By the end of the pilot intervention, HIV treatment retention and VL testing increased, and the percent agreement between community and health facility data improved. However, the proportion of C/ALHIV in treatment with an undetectable VL decreased.

The D2C strategy has the potential to be adopted in settings outside the United States, adding to the set of tools available to improve HIV treatment outcomes in countries most affected by the HIV epidemic.

The Data to Care (D2C) strategy uses multiple sources of complementary data on HIV clients and related services to identify individuals with gaps in HIV treatment. Although D2C has been widely used in the United States, there is no evidence on its use in other settings, such as countries most affected by the epidemic.

The D2C strategy was implemented within the context of a project that provided community-based support to children and adolescents living with HIV (C/ALHIV) in Mozambique. A data tracking tool and a standard operating procedure manual for local partner community organizations and health care facilities were developed to support the effort. Project staff met with local project implementing partners to discuss and coordinate the intervention in pilot health facilities.

The project initiated a pilot D2C intervention in 2019, working with 14 health facilities across 5 additional districts within 1 province. COVida project data were compared with clinical data from facilities serving C/ALHIV. The D2C intervention identified gaps in HIV treatment for a substantial number of C/ALHIV, and targeted support services were provided to address those gaps. Viral load (VL) monitoring was added in March 2020. Before the intervention, 71% of C/ALHIV reported to be on HIV treatment by their caregivers were documented as on treatment in health facilities. Support interventions targeted those not on treatment, and this proportion increased to 96% within 1 year of implementation. Additionally, 12 months later, the proportion of C/ALHIV with a documented VL test increased from 52% to 72%.

Introducing the D2C pilot intervention was associated with substantial improvements in HIV treatment for C/ALHIV, including increased linkage to and continuity in treatment and increased VL testing. D2C may be a useful approach to improve health outcomes for C/ALHIV in settings outside of the United States.

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