# CombinADO: a combination intervention strategy to improve health outcomes for adolescents living with HIV

> **NIH NIH UH3** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2022 · $881,536

## Abstract

UPROJECT ABSTRACT/ SUMMARY
Adolescents are at the core of the global HIV epidemic. They are highly vulnerable to HIV acquisition
and—for adolescents living with HIV (ALHIV)—at disproportionate risk for poor health outcomes
across the HIV care continuum. Retention rates, adherence to antiretroviral treatment (ART), and viral
suppression (VS) are alarmingly low among ALHIV, warranting urgent attention. Adolescence is a
time of rapid physical and psychological development, when youth move from childhood to adulthood
and experience multiple challenges as well as opportunities for growth, creativity, and learning. Youth
who enter this period under adverse conditions are ill prepared to cope with the impact of living with a
potentially fatal, stigmatized, transmissible infection and the need to adopt positive, health-seeking
behaviors, engage with health services, and adhere to daily ART regimens. In high prevalence
countries like Mozambique, the burden of living with HIV during this vulnerable developmental stage
is further exacerbated by fragile health systems and nascent ALHIV-specific differentiated service
delivery (DSD) models. At the same time, few specific interventions have been developed and tested
that address the needs of ALHIV. In response, we propose to develop and test a culturally-
appropriate, contextually-relevant, and theoretically-grounded adolescent-focused multicomponent
intervention strategy, CombinADO, among ALHIV in Zambézia, Mozambique. Using a human-
centered design approach, we will work with ALHIV, caregivers, health care providers, and local and
national stakeholders to develop and pilot this CombinADO intervention strategy consisting of four
components: 1) ALHIV peer navigation and support, 2) adolescent-friendly services, 3) mHealth
technologies, and 4) health communication messaging (Phase 1). In Phase 2, we propose to evaluate
the effectiveness of the CombinADO strategy on three milestones along the HIV care continuum: (a)
retention in HIV care, (b) ART adherence, and (c) VS among ALHIV using a cluster randomized
controlled trial design. The study builds on longstanding partnerships between ICAP at Columbia
University, the Mozambique Ministry of Health and other local stakeholders, all aiming to improve the
disease course as well as outcomes along the continuum of care for this highly vulnerable population,
adolescents living with HIV.

## Key facts

- **NIH application ID:** 10469506
- **Project number:** 5UH3HD096926-05
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** ELAINE Janine ABRAMS
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $881,536
- **Award type:** 5
- **Project period:** 2018-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10469506

## Citation

> US National Institutes of Health, RePORTER application 10469506, CombinADO: a combination intervention strategy to improve health outcomes for adolescents living with HIV (5UH3HD096926-05). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10469506. Licensed CC0.

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