A randomized stepped wedge trial of an intensive combination approach to roll back the HIV epidemic in Nigerian adolescents: iCARE Nigeria treatment support protocol.

Journal: PloS one

Volume: 18

Issue: 7

Year of Publication: 2023

Affiliated Institutions:  Division of Infectious Diseases and Institute for Global Health, Northwestern University, Chicago, IL, Unites States of America. Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, Unites States of America. Department of Child and Adolescent Psychiatry, and Centre for Child and Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria. Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan, Nigeria. Infectious Disease Institute, College of Medicine, University of Ibadan, Ibadan, Nigeria. Department of Family Medicine, University College Hospital, Ibadan, Nigeria. Department of Medical Social Sciences, Northwestern University, Chicago, IL, Unites States of America. Lagos University Teaching Hospital, Lagos, Nigeria. Department of Medicine, University of Jos and Jos University Teaching Hospital, Jos, Nigeria. Nigerian Institute of Medical Research, Lagos, Nigeria. Lagos State University College of Medicine, Ikeja, Nigeria. Department of Paediatrics, Olabisi Onabanjo University and Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria. Division of Adolescent Medicine, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, Unites States of America. Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria. Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, Unites States of America.

Abstract summary 

Nigeria is one of six countries with half the global burden of youth living with HIV. Interventions to date have been inadequate as AIDS-related deaths in Nigeria's youth have remained unchanged in recent years. The iCARE Nigeria HIV treatment support intervention, a combination of peer navigation and SMS text message medication reminders to promote viral suppression, demonstrated initial efficacy and feasibility in a pilot trial among youth living with HIV in Nigeria. This paper describes the study protocol for the large-scale trial of the intervention.The iCARE Nigeria-Treatment study is a randomized stepped wedge trial of a combination (peer navigation and text message reminder) intervention, delivered to youth over a period of 48 weeks to promote viral suppression. Youth receiving HIV treatment at six clinical sites in the North Central and South Western regions of Nigeria were recruited for participation. Eligibility criteria included registration as a patient at participating clinics, aged 15-24 years, on antiretroviral therapy for at least three months, ability to understand and read English, Hausa, Pidgin English, or Yoruba, and intent to remain a patient at the study site during the study period. The six clinic sites were divided into three clusters and randomized to a sequence of control and intervention periods for comparison. The primary outcome is plasma HIV-1 viral load suppression, defined as viral load ≤ 200 copies/mL, in the intervention period versus the control period at 48 weeks of intervention.Evidence-based interventions to promote viral load suppression among youth in Nigeria are needed. This study will determine efficacy of a combination intervention (peer navigation and text message reminder) and collect data on potential implementation barriers and facilitators to inform scale-up if efficacy is confirmed.ClinicalTrials.gov number, NCT04950153, retrospectively registered July 6, 2021, https://clinicaltrials.gov/.

Authors & Co-authors:  Taiwo Babafemi O BO Kuhns Lisa M LM Omigbodun Olayinka O Awolude Olutosin O Kuti Kehinde M KM Adetunji Adedotun A Berzins Baiba B Janulis Patrick P Akanmu Sulaimon S Agbaji Oche O David Agatha N AN Akinbami Akinsegun A Adekambi Abiodun Folashade AF Johnson Amy K AK Okonkwor Ogochukwu O Oladeji Bibilola D BD Cervantes Marbella M Adewumi Olubusuyi M OM Kapogiannis Bill B Garofalo Robert R

Study Outcome 

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Statistics
Citations :  Federal Ministry of Health of Nigeria. National guidelines for HIV prevention, treatment and care, 2016. 2016.
Authors :  20
Identifiers
Doi : e0274031
SSN : 1932-6203
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Study Design
Randomized Control Trial,Case Control Trial,Cross Sectional Study
Study Approach
Country of Study
Niger
Publication Country
United States