Dataset Information

Adapt for Adolescents: Protocol for a sequential multiple assignment randomized trial to improve retention and viral suppression among adolescents and young adults living with HIV in Kenya.

ABSTRACT:

Background

Adolescents and young adults living with HIV (AYAH) aged 14-24 years in Africa experience substantially higher rates of virological failure and HIV-related mortality than adults. We propose to utilize developmentally appropriate interventions with high potential for effectiveness, tailored by AYAH pre-implementation, in a sequential multiple assignment randomized trial (SMART) aimed at improving viral suppression for AYAH in Kenya.

Methods

Using a SMART design, we will randomize 880 AYAH in Kisumu, Kenya to either youth-centered education and counseling (standard of care) or electronic peer navigation in which a peer provides support, information, and counseling via phone and automated monthly text messages. Those with a lapse in engagement (defined as either a missed clinic visit by ≥14 days or HIV viral load ≥1000 copies/ml) will be randomized a second time to one of three higher-intensity re-engagement interventions: This study will evaluate which interventions and which dynamic sequence of interventions improve sustained viral suppression and HIV care engagement in AYAH at 24 months post-enrollment and assess the cost-effectiveness of successful strategies.

Discussion

The study utilizes promising interventions tailored to AYAH while optimizing resources by intensifying services only for those AYAH who need more support. Findings from this innovative study will offer evidence for public health programming to end the HIV epidemic as a public health threat for AYAH in Africa.

Trial registration

Clinicaltrials.govNCT04432571, registered June 16, 2020.

SUBMITTER: Abuogi LL

PROVIDER: S-EPMC10075086 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Publications

Adapt for Adolescents: Protocol for a sequential multiple assignment randomized trial to improve retention and viral suppression among adolescents and young adults living with HIV in Kenya.

Abuogi Lisa L LL Kulzer Jayne Lewis JL Akama Eliud E Odeny Thomas A TA Eshun-Wilson Ingrid I Petersen Maya M Shade Starley B SB Montoya Lina M LM Beres Laura K LK Iguna Sarah S Adhiambo Harriet F HF Osoro Joseph J Opondo Isaya I Sang Norton N Kwena Zachary Z Bukusi Elizabeth A EA Geng Elvin H EH

Contemporary clinical trials 20230220

<h4>Background</h4>Adolescents and young adults living with HIV (AYAH) aged 14-24 years in Africa experience substantially higher rates of virological failure and HIV-related mortality than adults. We propose to utilize developmentally appropriate interventions with high potential for effectiveness, tailored by AYAH pre-implementation, in a sequential multiple assignment randomized trial (SMART) aimed at improving viral suppression for AYAH in Kenya.<h4>Methods</h4>Using a SMART design, we will ...[more]

PMID: 36813086

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Dataset Information

Adapt for Adolescents: Protocol for a sequential multiple assignment randomized trial to improve retention and viral suppression among adolescents and young adults living with HIV in Kenya.

Background

Methods

Discussion

Trial registration

Publications

Adapt for Adolescents: Protocol for a sequential multiple assignment randomized trial to improve retention and viral suppression among adolescents and young adults living with HIV in Kenya.

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