Youth with evidence of virologic failure defined as an HIV VL\>400 copies/mL on two consecutive occasions at least 1 month apart will be eligible for enrollment. Youth will be randomized to a community based peer counseling support group or clinic based standard of care, with viral load, and drug monitoring evaluations at 3 month intervals to determine the efficacy of the intervention in improving adherence and virologic suppression.
Title The Peer Support Intervention - supporting HIV positive adolescents in Zimbabwe to improve HIV care continuum outcomes Short Title The Peer Support Intervention Study Design Prospective randomized study Study Duration 2 years Study Population 250 Youth (ages 10-24 years) with virologic failure Study Outcomes Primary Outcomes 1\. Virologic suppression rate in the The Peer Support Intervention group compared with the standard of care group following 48 weeks in the Peer Support Intervention. Secondary Outcomes 1. Frequency of acquired drug resistance mutations among youth failing ART. 2. Baseline prevalence of psychological distress among adolescents and young adults failing first line therapy 3. Prevalence of psychological distress (measured using PHQ-A and SSQ) after 48 weeks of enrolment in the Peer Support Intervention compared with the standard of care 4. Association between self-reported adherence, pill counts and objective surrogate markers of adherence obtained from plasma (viral load), DBS and hair (tenofovir concentrations). 5. Effectiveness of point mutation assays for the detection of drug resistance as compared with standard sequencing techniques. Description of Intervention Youth with evidence of virologic failure defined as an HIV VL\>400 copies/mL on two consecutive occasions at least 1 month apart will be eligible for enrollment. Youth will be randomized to a community based peer counseling support group or clinic based standard of care, with viral load, and drug monitoring evaluations at 3 month intervals to determine the efficacy of the intervention in improving adherence and virologic suppression. Study Sites Parirenyatwa Hospital Family Care Centre
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
214
Parirenyatwa Hospital
Harare, Zimbabwe
Virologic suppression rate in the Peer Support Intervention i group compared with the standard of care group following 48 weeks in the Peer Support Intervention.
Virologic suppression
Time frame: 2 years
Frequency of acquired drug resistance mutations among youth failing ART.
drug resistance mutations
Time frame: 2 years
Baseline prevalence of psychological distress among adolescents and young adults failing first line therapy
psychological distress
Time frame: 2 years
Prevalence of psychological distress (measured using PHQ-A and SSQ) after 48 weeks of enrolment in the Peer Support Intervention compared with the standard of care
psychological distress
Time frame: 2 years
Association between self-reported adherence, pill counts and objective surrogate markers of adherence obtained from plasma (viral load), DBS and hair (tenofovir concentrations).
(viral load), DBS and hair (tenofovir concentrations).
Time frame: 2 years
Effectiveness of point mutation assays for the detection of drug resistance as compared with standard sequencing techniques.
detection of drug resistance
Time frame: 2 years
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