Sixteen clinics have been randomised to receive either enhanced ART adherence support through the Zvandiri programme or usual adherence support. Adolescents aged 13 – 19 who are living with HIV are recruited at each site and will be followed for 96 weeks.
Adolescents attending clinics allocated to the usual care arm will receive ART and adherence support as set out in the Ministry of Health and Child Care (MoHCC) guidelines. Adherence support is provided by adult counsellors and nursing staff. After ART initiation, adolescents are seen monthly, with CD4 monitoring at six monthly intervals. MoHCC is only able to finance targeted viral load testing.
Adolescents attending clinics receiving the enhanced Zvandiri intervention will receive additional support as outlined in the following ‘What We Do’ section.
The primary hypothesis is that the Zvandiri programme will be more effective than usual care in reducing the proportion of adolescents who have died or are failing treatment (defined as viral load ≥1,000 copies/ml) at 96 weeks. The secondary hypotheses are that the Zvandiri programme improves i) retention in care and adherence to ART, and ii) reduces psychological distress over the 96 week follow-up period.
Through this study we intend to generate evidence of the Zvandiri model’s effectiveness, with children and adolescents living with HIV experiencing better HIV treatment, retention and prevention outcomes than those attending facilities without Zvandiri support.
To learn more about CeSHHAR visit their website here.