# FANMI: Community Cohort Care for HIV-Infected Adolescent Girls in Haiti

> **NIH NIH R01** · WEILL MEDICAL COLL OF CORNELL UNIV · 2020 · $425,300

## Abstract

Abstract: Sexually active HIV-infected adolescent girls are an extremely vulnerable and underserved
population. If treated promptly with antiretroviral therapy (ART) and retained in care, individuals have a near
normal life expectancy. Further, ART will decrease vertical and sexual HIV transmission in a population who are
sexually active, have high rates of pregnancy and multiple seronegative partners. However, in Haiti and other
resource poor countries, HIV-infected adolescents are three times more likely to be lost from care than adults,
with only approximately 50% of HIV-infected teens remaining in care at one year.
We have developed FANMI (My Family), an innovative model to improve HIV care for adolescent girls. HIV-
infected girls age 16-19 years attend monthly HIV care in cohorts of 5-8 peers. All HIV care takes place in a
community center rather than in a medical clinic. Each monthly visit integrates clinical care, peer group
counseling, and social activities in a single session by the same provider to simplify care and strengthen the
relationships between peers and providers. Preliminary data from our pilot study suggest dramatic
improvements in retention with 91% of girls remaining in care at one year.
Primary Aim: To conduct a randomized controlled trial at the GHESKIO Center in Port au Prince, Haiti. We
will randomize 160 HIV-infected girls age 16-19 years (80 per arm) to FANMI versus standard of care with the
primary study endpoint being alive and in care at 12 months. We will have >80% power to detect an
improvement in retention at 12 months from 60% in the standard group to 85% in FANMI.
Secondary Aims: To compare FANMI versus standard care on the following outcomes:
 a. Plasma HIV-1 RNA < 1000 copies/µl at 12 months. We predict that 30% of participants in the standard
 arm will have a suppressed viral load at 12 months compared to 60% in the FAMNI arm due to improved
 retention, increased visit attendance, and improved ART adherence.
 b. Sexual risk behavior: self-reported sexual activity, condom use, incidence of sexually-transmitted infections,
 and pregnancy rate over 12 months.
 c. Acceptability: We will conduct in-depth interviews to evaluate FANMI and factors associated with retention.
 d. Health care utilization and costs of FANMI versus standard care.
FANMI has the potential to dramatically improve HIV-infected adolescent treatment outcomes across the HIV
care cascade and serve as a model of adolescent HIV care in Haiti and other resource-poor countries.

## Key facts

- **NIH application ID:** 9989876
- **Project number:** 5R01HD091935-04
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Daniel W Fitzgerald
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $425,300
- **Award type:** 5
- **Project period:** 2017-09-01 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9989876

## Citation

> US National Institutes of Health, RePORTER application 9989876, FANMI: Community Cohort Care for HIV-Infected Adolescent Girls in Haiti (5R01HD091935-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9989876. Licensed CC0.

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