Teen clubs, Malawi

In Malawi, teen clubs were developed to address poor retention outcomes for adolescents and young adults. Clients aged 10-19 years, who are aware of their HIV status (fully disclosed), are able to join a teen club. These are run monthly* on a Saturday or Sunday, outside of normal clinic hours, and are only for adolescents. Teen clubs range in size from 15 to 200 clients.

The teen club is facilitated by a club mentor who is trained and mentored in the Baylor teen club curriculum. In larger clubs, younger and older adolescents are split to tailor psychosocial support with older teens also receiving SRH literacy. During the club activities, a nurse sees each adolescent individually for their ART refill and clinical review. Viral loads are taken according to national guidelines at six months, two years and then two yearly thereafter.

Some facilities with high numbers enrolled in the model continue to see the adolescents monthly for psychosocial support but 2 monthly for clinical review and provide 2-month ART refills. Others have moved fully onto a 2-monthly visit schedule. Attending adolescents receive reimbursement for transport and a snack. Teen clubs are an example of a facility-based individual model and are a psychosocial intervention (pre-existing adolescent support group run on a Saturday) that was adapted to provide differentiated ART delivery.

Eligibility

Aged 10-19 years, fully disclosed

Building Blocks

ART refills

Clinical consultation

Psychosocial support

*Variation between facilities, with most seeing each adolescents monthly for all three services. A few facilities with higher client loads either see adolescents monthly for psychosocial support but only 2 monthly for ART refill and clinical review or have moved fully onto a 2-monthly visit schedule.

Similar teen clubs exist in Botswana, Lesotho, Swaziland, Uganda and Tanzania.