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.

Youth have the highest incidence of HIV in sub-Saharan Africa but the lowest rates of testing. The feasibility and acceptability of HIV self-testing in adolescents and young people (FAST) study will investigate whether self-testing using oral mucosal transudate tests could be a solution. Participants will have the option of downloading a mobile app, ITHAKA, which gives step by step instructions on how to test. We will distribute 5000 self-testing kits to youth aged 16-24 at tertiary education institutions and community centres, over 12 months and measure the proportion of people who complete a test and, if necessary, are linked to care. 

The project is an open label randomized trial among HIV infected children and adolescents  receiving ART at 8 treatment outreach sites near their homes provided by Chidamoyo Mission Hospital. We will implement VL testing at “near point of care” using the GeneXpert Quant to evaluate the safety, clinical and virologic outcomes of near POC monitoring of virus load at the  Chidamoyo Christian Hospital in Mashonaland West Zimbabwe. 600 subjects are randomized 1:1 to receive Standard of care (SOC) VL or near point-of-care (nPOC) VL every 6 months with confirmatory testing  of VL  > 1,000 copies/ml and drug switching. Lower cost genotyping will be provided on confirmed Virologic failure samples as requested by providers.