Improving Care and Community Representation for Adolescents and Young Adults Living With HIV in West Africa (TRANSITIONS)

Inclusive Programme for the Optimisation of Health and Well-being of HIV-positive Young People (15-24 Years) and for the Promotion of Their Community Representation in Senegal and Burkina Faso (2021 => 36 Months) (TRANSITIONS)

Context: HIV-positive young people aged 15 to 24 are a heterogeneous population in terms of gender, age, mode of transmission, sexual orientation and risk-taking. This most vulnerable age group is at greater risk of disruption of medical care and poor compliance, and has greater needs for psychosocial support and differentiated health services. It remains highly invisible in West African countries, both in the definition of care policies and in the allocation of resources and community representation.

Objectives: The overall objective of the project is to contribute to the improvement of retention in care, health and well-being of adolescents and young adults living with HIV (AYAHIV) and to support their integration into the community space.

SO1: Support the operationalisation of the transition of HIV-infected adolescents from paediatrics to adult medical services in a stakeholder inclusive, participatory and responsive approach SO2: Contribute to the empowerment and autonomy of adolescents and young adults living with HIV in the project environment SO3: Contribute to the generation and dissemination of evidence-based information and recommendations on the situation and needs of adolescents and young adults, including key populations, living with HIV

Target: Approximately 67 caregivers∙e∙s ≥ 25 years old, of which 64%F, 30 peer-referent associations of 20-24 years old (ratio F/H= 1:1), 700 AYAHIV ≥ 15 years old, of which 47%F, in paediatrics and 500-600 AYAHIV aged 15-24 years old in adult medicine, of which 41%F, and including AYAHIV associations Summary of activities: Based on the capitalisation and pooling of experiences of partner teams, the project proposes to support the implementation of transition in a pragmatic approach, adapted to the needs of adolescents and inclusive of carers, adolescents and community peers. More globally, it contributes to improving the health, empowerment and autonomy of HIV-positive youth, including key populations, in particular through support to training, structuring and community representation of youth associations, documentation of the conditions of entry into care and their specific needs, including digital health, production and availability of evidence and recommendations in this West African context and advocacy building.

A multidisciplinary and participatory research-action project, carried out by the IRD in Senegal and financed by Sidaction, accompanies the three specific objectives of the project.

Study Overview

• Status: Active, not recruiting
• Conditions: HIV Infections; Adolescent Behavior; Transition

Detailed Description

Context: HIV-positive young people aged 15 to 24 are a heterogeneous population in terms of gender, age, mode of transmission, sexual orientation and risk-taking. This most vulnerable age group is at greater risk of disruption of medical care and poor compliance, and has greater needs for psychosocial support and differentiated health services. It remains highly invisible in West African countries, both in the definition of care policies and in the allocation of resources and community representation.

Objectives: The overall objective of the project is to contribute to the improvement of retention in care, health and well-being of adolescents and young adults living with HIV (AYAHIV) and to support their integration into the community space.

SO1: Support the operationalisation of the transition of HIV-infected adolescents from paediatrics to adult medical services in a stakeholder inclusive, participatory and responsive approach SO2: Contribute to the empowerment and autonomy of adolescents and young adults living with HIV in the project environment SO3: Contribute to the generation and dissemination of evidence-based information and recommendations on the situation and needs of adolescents and young adults, including key populations, living with HIV

Target: Approximately 67 caregivers∙e∙s ≥ 25 years old, of which 64%F, 30 peer-referent associations of 20-24 years old (ratio F/H= 1:1), 700 AYAHIV ≥ 15 years old, of which 47%F, in paediatrics and 500-600 AYAHIV aged 15-24 years old in adult medicine, of which 41%F, and including AYAHIV associations Summary of activities: Based on the capitalisation and pooling of experiences of partner teams, the project proposes to support the implementation of transition in a pragmatic approach, adapted to the needs of adolescents and inclusive of carers, adolescents and community peers. More globally, it contributes to improving the health, empowerment and autonomy of HIV-positive youth, including key populations, in particular through support to training, structuring and community representation of youth associations, documentation of the conditions of entry into care and their specific needs, including digital health, production and availability of evidence and recommendations in this West African context and advocacy building.

A multidisciplinary and participatory research-action project, carried out by the IRD in Senegal and financed by Sidaction, accompanies the three specific objectives of the project.

Expected impact :

• Seamless operationalisation of the supported and coordinated transition in care process and scaling up to the level of the 12 countries of the EVA network.
• Young associative actors are able to advocate to guide decision-makers, based on the evidence they have helped to produce (participatory approach)
• The ultimate change, expected at the end of the project, is that institutional stakeholders will integrate these recommendations into the national programme for the care of PLHIV, both operationally and financially.

• Study Type: Observational
• Enrollment (Actual): 267

Contacts and Locations

• Study Contact: Name: Cécile CAMES, PhD; Phone Number: +33670282877; Email: cecile.cames@ird.fr
• Study Contact Backup: Name: Aminata DIACK, MD; Email: adiackmbaye@gmail.com

Study Locations

• Burkina Faso
  • Ouagadougou, Burkina Faso
    • CHU CDG
  • Ouagadougou, Burkina Faso
    • CHU YO
• Senegal
  • Dakar, Senegal, 00000
    • Chnear Albert Royer
  • Guediawaye, Senegal
    • Centre hospitalier Roi Baudouin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 15 years to 24 years (Child, Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The target population of the study is all HIV-infected adolescents (mainly through mother-to-child transmission) aged 15 to 24 years, eligible for transition to care and followed up in the active files of reference centers that are members of the EVA network in Senegal and Burkina Faso.

Description

Inclusion Criteria:

• being HIV-infected
• aged 15 to 24 years
• on antiretroviral treatment
• HIV status disclosed
• caretaker's written consent (if < 18 years)
• adolescent's written consent

Exclusion Criteria:

• mental illness

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
retention in care	percent of adolescents who remain in care	Month 12
retention in care	percent of adolescents who remain in care	Month 21

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
virologic suppression	percent of adolescents who maintain or reach undetectable viral load	Month 12
virologic suppression	percent of adolescents who maintain or reach undetectable viral load	Month 21
quality of life in relation to health	percent of adolescents who improve their score of quality of life in relation to health	Month 12
quality of life in relation to health	percent of adolescents who improve their score of quality of life in relation to health	Month 21
level of preparedness to adult care	percent of adolescents who improve their score of preparedness to adult care	Month 12

Collaborators and Investigators

• Sponsor: Institut de Recherche pour le Developpement
• Collaborators: Cheikh Anta Diop University, Senegal; Sidaction; EXPERTISE FRANCE, Paris France; Children and HIV Network in AFRICA (EVA), Dakar Senegal

Study record dates

Study Major Dates

• Study Start (Actual): April 7, 2021
• Primary Completion (Actual): January 1, 2023
• Study Completion (Estimated): April 1, 2024

Study Registration Dates

• First Submitted: November 10, 2021
• First Submitted That Met QC Criteria: May 31, 2022
• First Posted (Actual): June 6, 2022

Study Record Updates

• Last Update Posted (Actual): September 28, 2023
• Last Update Submitted That Met QC Criteria: September 26, 2023
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Keywords: adolescent; transition; community; HIV infection; west africa; peer
• Additional Relevant MeSH Terms: RNA Virus Infections; Virus Diseases; Infections; Blood-Borne Infections; Communicable Diseases; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; Immunologic Deficiency Syndromes; Immune System Diseases; Urogenital Diseases; Genital Diseases; HIV Infections
• Other Study ID Numbers: 999999

Plan for Individual participant data (IPD)

Study Data/Documents

1. podcasts
   Information comments: Experiences of participatoy research with the participants included in the Transitions Study and their peers.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No