Community based interventions to improve HIV outcomes in young people: a cluster randomised trial in Zimbabwe
Community based interventions to improve HIV outcomes in young people: a cluster randomised trial in Zimbabwe: (CHIEDZA)
PI: Professor Rashida Ferrand
CHIEDZA is a cluster randomised trial which is Community based interventions to improve the HIV outcomes in young people. Adolescents and Young People (AYP) fare disproportionately poorly across the HIV care continuum compared to other age-groups: the prevalence of undiagnosed HIV is substantially higher, and coverage of and adherence to ART is lower, resulting overall in worse virological outcomes.
Aim: The aim is to determine the impact of an integrated community-based package of HIV services incorporating HIV testing, linkage to care and ongoing adherence support, combined with sexual and reproductive health services and general health services on population level HIV viral load among AYP (defined in this study as those aged between 16 to 24 years) in a high HIV prevalence setting.
Design: This is a two-arm cluster-randomised trial in 24 clusters randomised 1:1 to standard of care or to the intervention package.
Intervention: Community-based package of services for AYP that includes: HTC, ART delivery ART, CAPS groups and mhealth for adherence support, condoms, MHM, STI treatment, contraception, referral for VMMC, risk reduction counselling and general health information and counselling. The intervention will be implemented over a two-year period. The intervention will be implemented in 12 clusters, each with a population of approximately 2500 AYP.
Study Outcomes: The study outcomes will be determined at a population level through a community cross-sectional survey two years following the implementation of the intervention. The primary outcome is the proportion of AYP with HIV with a Viral load < 1000 copies/ml. The secondary outcomes will reflect each step of the HIV care cascade:
Proportion with HIV who know their HIV status, proportion of those who know their status who are taking ART, of those who know their HIV-positive status, who are currently taking ART, proportion of those taking ART who are virally suppressed. SRH knowledge, risks and behaviour will also be assessed.
Study population: The end-line survey will recruit 1000 18-24 year olds per cluster (total 24000).
Study sites: The study will be conducted in 3 provinces in Zimbabwe: Harare, Mashonaland East and Mashonaland West.
Study Duration: The planned duration of the entire study will be 4 years
This project is funded by the Wellcome Trust.