# Strategic antiretroviral therapy and HIV testing for youth in rural Africa

> **NIH NIH UH3** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $1,904,969

## Abstract

SUMMARY
Despite encouraging gains in HIV treatment outcomes among adults with HIV in Sub-Saharan Africa,
adolescents and young adults(10-24 years of age) living with HIV (AYAH) are being left behind with
young women disproportionately affected. AYAH have worse rates of HIV testing, linkage to care,
retention in care, and dramatically lower rates of HIV viral suppression. Our goal is to evaluate a
strategic ART combination intervention for AYAH (SATURN) in a cluster randomized controlled trial (RCT)
of 1,400 AYAH in 28 clinics in rural Uganda and Kenya. SATURN is an innovative life-stage adapted
approach to improve ART uptake, adherence, retention and virologic suppression among female and male
youth. The life-stage adapted, combination SATURN intervention is based on premise that current
approaches to engaging AYAH are challenged by lack of dynamic flexibility and care adaptation to the
significant trajectories of cognitive, social, and life-stage developmental events that occur in
adolescence and early adulthood. Our intervention is based on behavioral theory, implementation
science, youth/provider input, and process and outcome feasibility and pilot data from the region. In
AIM 1, Phase-I (UG3), we will: a) Implement youth-led HIV testing and linkage programs using a
community-based participatory research (CBPR) to reach AYAH who are undiagnosed or are not engaged in
care b) Initiate the clustered RCT of SATURN intervention compared to standard of care among AYAH in 8
of the planned 28 clinics in rural Uganda and Kenya. In AIM 2, Phase-2 (UH3) we will: Complete RCT
enrollment of AYAH from 28 clinics and compare the rate of retention and virologic suppression at 2
years in SATURN clinics vs control; and 2a) Identify the mechanisms of action, barriers and facilitators of
the SATURN implementation at the community, clinic organization, provider, and patient levels using mixed
methods qualitative and quantitative assessments. 2b) Estimate the incremental costs and gains associated
with SATURN through cost effectiveness analysis. Transition Milestones to move from UG3 to UH3: a)
Enroll at least 400 youth from the first 8 clinics to the SATURN RCT; 2) Of those enrolled, 20% will be new or
out-of-care diagnoses; 3) Achieve at least 70% retention with virologic suppression at 1 year in intervention
communities. This research builds upon highly productive long-standing collaborations between Ministries of
Health in Uganda and Kenya, African and US research organizations, and PEPFAR implementing partners
with local community participation and substantial AYAH targeted formative work in Uganda and Kenya and is
directed at eventual dissemination and sustainability.

## Key facts

- **NIH application ID:** 10469425
- **Project number:** 5UH3HD096915-05
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Diane V Havlir
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1,904,969
- **Award type:** 5
- **Project period:** 2018-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10469425

## Citation

> US National Institutes of Health, RePORTER application 10469425, Strategic antiretroviral therapy and HIV testing for youth in rural Africa (5UH3HD096915-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10469425. Licensed CC0.

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