Peer-Educator-coordinated vs Nurse-coordinated ART Refill for Adolescents and Young Adults Living With HIV in Lesotho (PEBRA)
HIV/AIDS
About this trial
This is an interventional health services research trial for HIV/AIDS focused on measuring HIV, Sub-Sahara Africa, Lesotho, Differentiated Service Delivery, Adolescents and young adults living with HIV, ART service, Preference-based
Eligibility Criteria
Eligibility - clusters
Inclusion criteria:
- the cluster is a public or missionary health center from the study districts, that offers ART services
the cluster has at least one PE who is willing to participate and fulfills the following criteria:
- underwent the Sentebale Peer-Educator two-weeks training
- attended and successfully passed the study training assessment
Exclusion criteria:
- health facility authority opposed to trial participation (verbal assent)
- the health facility is a hospital
- the health facility is situated in an area without cellphone signal
Eligibility - individuals
- Individual is living with HIV and in care in a participating cluster
- Individual is 15-24 years old (AYPLHIV)
- Informed consent given
- Declares to seek the next follow-up visit at the same health facility
Sites / Locations
- Boiketsiso HC
- Linakeng HC
- Makhunoane HC
- Motete HC
- Muela HC
- Ngoajane HC
- Rampai HC
- St. Paul HC
- St. Peters HC
- Tsime HC
- Ha Lejone HC
- Pontmain
- Libibing HC
- Linakaneng HC
- Malefiloane HC
- Mapholaneng HC
- Moeketsane HC
- Molikaliko HC
- St. James HC
- St. Martins HC
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Intervention
Control
Participants in the intervention clusters are offered the PEBRA model. In the PEBRA model the ART visit/refill is coordinated by the Peer-Educator (PE) according to the participants' preferences, using a tablet-based application, called PEBRApp. The preference assessment entails the following three domains of DSD: ART Refill SMS notifications Support In each of the domains, the participants' preferences will be assessed and the most feasible option will be selected. The PEBRApp not only helps the PE to assess each participants' preference, but also to keep track of the ART refill, and to ensure regular contact between the PE and the participant. The model includes key innovative options such as individualized automatic SMS notifications and decentralized ART delivery.
Participants in the control clusters are offered standard of care: ART visit/refill is coordinated by the nurse, is mostly clinic-based, not adapted to youth, and differentiated according to clinical values (i.e. if VL suppressed then option of ART Refill in a Community Adherence Club).