# VS4A: VITAL Start (Video-Intervention to Inspire Treatment Adherence for Life) for Adolescents, a video intervention to improve retention and adherence to ART among adolescents living with HIV

> **NIH NIH UG1** · BAYLOR COLLEGE OF MEDICINE · 2024 · $1,082,195

## Abstract

PROJECT SUMMARY/ABSTRACT
The 1.7 million adolescents living with HIV (ALHIV) globally urgently need interventions to help improve
retention, adherence, and ultimately viral load suppression (VLS). With both high rates of incident infection
and some of the lowest VLS rates, ALHIV experience high mortality with approximately 100 deaths per day.
Successful interventions to improve retention and VLS among ALHIV in low- and middle-income countries
(LMIC) remain limited. Video-based interventions that provide counseling to patients living with HIV have
increased patient HIV knowledge, supported disclosure, fostered behavior change, and improved treatment
adherence. Targeted messaging can be woven into culturally relevant films with engaging storylines and
delivered at critical teachable moments. Films can be shown in high-volume clinics to deliver standardized
counseling content while freeing up HCW time. While video-based interventions have the potential to address
barriers to ALHIV ART retention and adherence, they are not commonly used throughout Sub-Saharan Africa
(SSA). Our team was one of the first to pilot and study the impact of a video-based intervention on HIV service
delivery; preliminary results have suggested high levels of patient and HCW satisfaction, improved ART
knowledge, adherence, and retention. Based on these promising results, we propose to adapt, assess and
support scale up of a tailored, video-based counseling package for ALHIV: VITAL (Video Intervention to Inspire
Treatment Adherence for Life) Start for Adolescents (VS4A). Our study will examine the impact of VS4A on
the primary composite outcome of retention and adherence (viral load <1000 copies/ml) in a multisite two-arm
cluster randomized controlled trial (CRCT) with 1:1 randomization in Malawi. Our overall hypothesis is that
VS4A will a) achieve broad reach, b) be acceptable and feasible to implement, c) improve adolescent
VLS and several secondary outcomes; and d) be cost-effective at scale. If effective, VS4A can be an
innovative, scalable tool to improve service delivery for ALHIV while also liberating HCW time and reducing
health system burden in Malawi. Building on a 15-year partnership with the Malawi Ministry of Health (MOH), a
track record of excellence and innovation in service to ALHIV, and a robust implementation science research
portfolio, our team is poised to successfully implement the VS4A study and program and to use findings to
support rapid, wide-scale dissemination and scale up.

## Key facts

- **NIH application ID:** 10934534
- **Project number:** 5UG1MD019436-02
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** Saeed Ahmed
- **Activity code:** UG1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,082,195
- **Award type:** 5
- **Project period:** 2023-09-24 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10934534

## Citation

> US National Institutes of Health, RePORTER application 10934534, VS4A: VITAL Start (Video-Intervention to Inspire Treatment Adherence for Life) for Adolescents, a video intervention to improve retention and adherence to ART among adolescents living with HIV (5UG1MD019436-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10934534. Licensed CC0.

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