Adapting and testing a combination peer navigation and mHealth intervention to enhance treatment engagement and viral suppression among youth

NIH RePORTER · NIH · R34 · $685,492 · view on reporter.nih.gov ↗

Abstract

Nigeria is one of the six countries with half of the global burden of youth with HIV. HIV prevalence among young men who have sex with men (YMSM), ages 15-24 is over six-fold that of the general population of youth. Furthermore, across risk groups, youth have disproportionately worse HIV care outcomes in comparison to adults. There are challenges to treatment engagement and viral suppression among YMSM. While adult HIV care routinely begins at age 15, youth-adapted programs to support successful care engagement are rare, particularly for YMSM, who typically prefer to receive care in multipurpose key population-focused community-based centers, which often lack evidence-driven, youth-specific interventions that include psychosocial and medication adherence support for best outcomes. This preference for key population-focused community centers is rational given the country’s unfavorable social milieu and legal environment for YMSM. Evidence-based and scalable approaches, incorporating preferences for community centers, are needed to have the greatest impact on ART outcomes among YMSM. Thus, we propose to adapt and test the Intensive Combination Approach to Rollback the Epidemic in Nigeria, to improve HIV treatment engagement, medication adherence, and viral suppression among YMSM where they receive care. This intervention model uses evidence-based and youth-specific approaches, including peer navigation and daily text message reminders in combination. This intervention approach has demonstrated initial efficacy in a general population of youth in a traditional HIV clinic at the University of Ibadan, Nigeria. In this study, we will expand it to YMSM cared for in community centers using a community and outreach-based delivery approach. Our goal is to develop a practical and scalable enhancement to HIV treatment for YMSM where they receive care. Our aims are to: 1) adapt the HIV clinic-based intervention to a community-based outreach approach for YMSM ages 15-24 living with HIV in Ibadan, Nigeria; 2) test the adapted intervention for initial efficacy, feasibility, satisfaction, and acceptability among YMSM and 3) evaluate implementation indicators based on RE-AIM (reach, adoption, implementation, maintenance) to inform widespread dissemination and scalability of the adapted intervention.

Key facts

NIH application ID
10619071
Project number
1R34MH132453-01
Recipient
NORTHWESTERN UNIVERSITY
Principal Investigator
Lisa Mary Kuhns
Activity code
R34
Funding institute
NIH
Fiscal year
2023
Award amount
$685,492
Award type
1
Project period
2023-09-01 → 2026-08-31