Adolescents Living With HIV (ALWH): Social Networks, Adherence and Retention

NCT04077047 | Completed

• 2 other identifiers: IRB000999515K08MH118965-02
• Study Type: interventional
• Target: 60
• Locations: 2 countries
• Sites: 2

Brief Summary

human immunodeficiency virus / acquired immunodeficiency syndrome (HIV/AIDS) is the second leading cause of death in Africa. Adolescents living with HIV (ALWH) are at increased risk for HIV-related morbidity and mortality due to poor retention in HIV care and suboptimal antiretroviral therapy (ART) adherence. Despite having the world's largest population of Adolescents living with HIV (ALWH) (15-24 years, n=870,000), only 14% of South African ALWH are on ART, 12% are retained in HIV care 1-2 years after ART initiation, and 10% are virally suppressed. During treatment interruption, the effects of ART quickly reverse, increasing transmission risk, treatment resistance, and potentially fatal complications. Unless their treatment retention and adherence improves, ALWH will continue to transmit the virus to their sexual partners and die prematurely. While social support is often viewed as a bridge that joins ALWH to key resources within their environments, little is known about which types of social support are most impactful and from whom within their network, particularly among ALWH in endemic countries. Moreover, many South African ALWH lack social support from key social network members due to lack of HIV status disclosure, increasing their risk for poorer HIV-related outcomes when compare to their disclosed peers. Social network interventions (i.e., those that leverage the resources within one's network to improve behaviors and outcomes) that meet the needs of both ALWH who are disclosed and non-disclosed are needed, but lacking. Such inventions have the potential to facilitate appraisal support, during which ALWH receive targeted assistance with identifying appropriate and trustworthy people in their lives. More broadly, there exists a lack empirically supported interventions aimed at improving retention in HIV care and ART adherence for ALWH in low-middle income countries. This proposal follows the multiphase optimization strategy (MOST), a comprehensive framework for optimizing and evaluating multicomponent behavioral interventions.

Conditions

HIV/AIDS

Keywords

Adolescents

Outcome Measures

Primary Outcomes (2)

• Feasibility: exit interviews

  Measured using exit interviews

  12 month follow up

• Acceptability: exit interviews

  Measured using exit interviews

  12 month follow up

Secondary Outcomes (21)

• Change in HIV stigma & discrimination

  baseline, 6 month, and 12 month follow up

• Change in HIV knowledge

  baseline, 6 month, and 12 month follow up

• Change in autonomy

  baseline, 6 month, and 12 month follow up

• Change in sense of community

  baseline, 6 month, and 12 month follow up

• Change in basic psychological needs

  baseline, 6 month, and 12 month follow up

Study Arms (1)

iEngage

EXPERIMENTAL

The intervention is a network-based, social support intervention to improve ALWH retention in HIV care and ART adherence. The specific intervention will be developed during Aim 2 of the study and uses qualitative findings, along with data from Aim 1, to develop an interventions that integrates participant feedback and borrows components from two existing interventions

Behavioral: iEngage

Interventions

iEngage BEHAVIORAL

The intervention is a network-based, social support intervention to improve Adolescents living with HIV (ALWH) retention in HIV care and antiretroviral therapy (ART) adherence

Also known as: network-based, social support intervention

iEngage

Eligibility Criteria

• Age: 15 Years - 21 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• reside in study area
• able to provide consent or assent
• agreeable to allowing the research team to have access to their clinic data to assess retention in human immunodeficiency virus- (HIV) care and antiretroviral therapy (ART) adherence
• each Adolescents living with HIV (ALWH) must recruit at least one social network member to participate in the intervention with them

You may not qualify if:

• None

Sponsors & Collaborators

• Wake Forest University Health Sciences: lead
• National Institute of Mental Health (NIMH): collaborator

Study Sites (2)

Wake Forest University School of Medicine

Winston-Salem, North Carolina, 27101, United States

Location

Desmond Tutu Health Foundation

Cape Town, South Africa

Location

MeSH Terms

Conditions

Acquired Immunodeficiency Syndrome

Condition Hierarchy (Ancestors)

HIV Infections; Blood-Borne Infections; Communicable Diseases; Infections; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; RNA Virus Infections; Virus Diseases; Slow Virus Diseases; Genital Diseases; Urogenital Diseases; Immunologic Deficiency Syndromes; Immune System Diseases

Study Officials

• Tiarney Ritchwood, PhD

  Wake Forest University Health Sciences

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 21, 2019
• First Posted: September 4, 2019
• Study Start: September 1, 2022
• Primary Completion: July 17, 2025
• Study Completion: July 31, 2025
• Last Updated: January 2, 2026

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

US (1); ZA (1)