# Strategies to Achieve Viral Suppression for Youth with HIV (The SAVVY Study)

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $489,489

## Abstract

PROJECT SUMMARY
Adolescents and young adults (AHIV) ages 12-30 years have disproportionately poorer outcomes across the
HIV care continuum, including lower rates of adherence to oral ART (oART) and viral suppression (VS) than
older adults, correlating with individual risk of poor health and disease progression and public health risk of
secondary transmission. AHIV are a priority population in the Ending the HIV Epidemic in the United States
Initiative (EHE). Unique multi-layered factors (e.g., cognitive development, psychosocial determinants, system
barriers) underlie AHIV's nonadherence and VS; therefore, AHIV-specific interventions are needed to address
those factors and ultimately improve VS. Toward this aim, our group has shown that AHIV are more likely to be
retained in care and achieve and maintain VS if cared for at clinics with youth-friendly structures and services,
more likely to achieve VS with single tablet regimens (STR) vs. multi-tablet oral ART (oART) regimens, and have
high interest in ART strategies not taken orally, specifically long-acting injectable ART (LAI-ART). These findings
underscore the importance of engaging AHIV in decision-making and providing access to alternative biomedical
strategies that obviate daily adherence, like LAI-ART, should they choose. Though uptake and rollout has been
slow, LAI-ART (cabotegravir/rilpivirine) administered q4-8 weeks has been approved for HIV treatment in those
>12 years-old who have achieved VS—excluding up to 50% of all AHIV due to their decreased likelihood of VS.
We have reported provider biases and disparities in ART initiation by patient age and have concern that AHIV
may have decreased access to LAI-ART, resulting in a tiered system that precludes LAI-ART access from those
who may want and benefit from it most. AHIV need biomedical and care delivery innovations to address their
challenges meeting EHE goals by optimizing feasibility of delivering novel biomedical tools for AHIV through
minimizing medication and healthcare system barriers. The central hypothesis of the Strategies to AchieVe
Viral Suppression for Youth with HIV (SAVVY) Study is that informed choice, counseling on ART options,
and facilitating access, will increase rates of achieving and sustaining VS among AHIV. The study
proposes to present and solicit informed choice of ART among both AHIV with and without VS, including
facilitating LAI-ART (if VS can be achieved). For AHIV who prefer LAI-ART, the SAVVY intervention will support
AHIV in successfully meeting or maintaining criteria (VL<50 copies/mL) for LAI-ART consideration, and deploy
a focused team that facilitates access to LAI-ART. Study outcomes include VS and health-related quality of life
(HRQOL) for AHIV undergoing the SAVVY intervention, identification of implementation barriers utilizing an
established implementation science framework, and assessment of the cost-effectiveness of SAVVY using an
economic-epidemiologic model. Our interdisciplinary team has ...

## Key facts

- **NIH application ID:** 10892262
- **Project number:** 5R01MH134724-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** ALLISON L AGWU
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $489,489
- **Award type:** 5
- **Project period:** 2023-07-21 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10892262

## Citation

> US National Institutes of Health, RePORTER application 10892262, Strategies to Achieve Viral Suppression for Youth with HIV (The SAVVY Study) (5R01MH134724-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10892262. Licensed CC0.

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