Integrating HPV Vaccination Into HIV Care Services for Adolescent Girls Living With HIV in Zambia

November 6, 2026 updated by: Washington University School of Medicine

Integrating HPV Vaccination Into HIV Care Services for Adolescent Girls Living With HIV in Zambia: A Mixed-Methods Feasibility and Implementation Evaluation Study

HPV vaccination can prevent up to 90% of cervical cancer cases, but adolescents living with HIV (ALHIV) require additional doses for sufficient protection beyond the single dose recommended for adolescent girls in Zambia. There are challenges to ensuring ALHIV receive all necessary doses without increasing burden and stigma on the girls. Integrating HPV vaccination into ART clinics can be an effective approach to doing so but requires a multi-pronged strategy for successful implementation.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

40

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Zambia
    • Copperbelt
      • Ndola, Copperbelt, Zambia
        • Tropical Diseases Research Centre Ndola
        • Contact:
          • Sam Miti, MD
          • Phone Number: +260 96 6293508
        • Principal Investigator:
          • Sam Miti, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Healthcare workers providing HIV, adolescent or vaccination services at one of the 3 study sites (including registration, data collection, clinical care, pharmacy, administration)
  • Facility leadership, district, provincial, national health managers and program coordinators

Exclusion Criteria:

- No involvement in HIV, adolescent or vaccination services

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Tertiary Care Cohort

Participants in this arm will complete the multi-component training that aims at improving healthcare worker competencies around HPV and HPV vaccines. Participants will complete pre- and post- training questionnaires, as well as quantitative surveys administered at baseline, 6 months, and 12 months that measure implementation outcomes.
Behavioral: HPV-HIV integration training and Audit & Feedback support

The HPV-HIV integration training covers six core modules. The six core modules include HPV epidemiology and vaccine indications, identification of eligible adolescents, adolescent-centered communication, workflow integration procedures, documentation and reporting systems, and strategies to reduce missed opportunities. The training will occur over a period of 3 days. Participants will receive facilitator manuals, screening tools, referral algorithms, and job aids. Audit & Feedback of vaccination data will support integration and documentation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Tertiary Care Cohort: Changes in HPV knowledge
Time Frame: At time of pre-training assessment (day 1) and at time of post-training assessment (day 3) (total estimated time: 3 days)

Changes in HPV knowledge will be assessed by changes in the HPV knowledge portion of the pre/post training questionnaire. This portion of the questionnaire is composed of 10 questions that are answered True/False/Don't Know. Correct answers are scored as 1 point. The total score is calculated by the number of questions answered correctly with a total score range of 0-10. A higher score represents higher knowledge.
At time of pre-training assessment (day 1) and at time of post-training assessment (day 3) (total estimated time: 3 days)
Tertiary Care Cohort: Changes in HPV vaccine knowledge
Time Frame: At time of pre-training assessment (day 1) and at time of post-training assessment (day 3) (total estimated time: 3 days)

Changes in HPV vaccine knowledge will be assessed by changes in the HPV vaccine knowledge portion of the pre/post training questionnaire. This portion of the questionnaire is composed of 6 questions with one question being open ended, three questions answered as True/False/Don't Know, and two questions answered as Strongly disagree, Disagree, Agree, Strongly agree, or Don't Know. Correct answers are scored as 1 point. The total score is calculated by the number of questions answered correctly with a total score range of 0-6. A higher score represents higher knowledge.
At time of pre-training assessment (day 1) and at time of post-training assessment (day 3) (total estimated time: 3 days)
Tertiary Care Cohort: Changes in Self-Efficacy and Provider Confidence score
Time Frame: At time of pre-training assessment (day 1) and at time of post-training assessment (day 3) (total estimated time: 3 days)

Changes in Self-Efficacy and Provider Confidence score will be assessed by changes in the Self-Efficacy and Provider Confidence portion of the Post Training Survey. This portion of the questionnaire is composed of 4 questions answered as either Strongly disagree, Disagree, Neither agree nor disagree, Agree, or Strongly agree. Correct answers are scored as 1 point. The total score is calculated by the number of questions answered correctly with a total score range of 0-4. A higher score represents greater self-efficacy/confidence.
At time of pre-training assessment (day 1) and at time of post-training assessment (day 3) (total estimated time: 3 days)
Tertiary Care Cohort: Proportion of eligible/invited staff that attended training
Time Frame: At start of training through completion of training (total estimated time: 3 days)
At start of training through completion of training (total estimated time: 3 days)
Tertiary Care Cohort: Feasibility as assessed by training attendance
Time Frame: At start of training through completion of training (total estimated time: 3 days)
At start of training through completion of training (total estimated time: 3 days)
Tertiary Care Cohort: Feasibility of Intervention Measure (FIM) score
Time Frame: At time of post-session survey completion on day 3 (total estimated time: 1 day)

FIM will be assessed by implementation champions' response to the 4 items in from the FIM measure on the follow up survey. FIM is measured by a 5-point Likert scale: 1-Completely disagree, 2-Disagree, 3-Neither agree nor Disagree, 4-Agree, or 5-Completely agree. A higher score indicates greater feasibility of the intervention in practice. Scores above 3.0 are typically viewed as favorable/positive.
At time of post-session survey completion on day 3 (total estimated time: 1 day)
Tertiary Care Cohort: Adoption measured as rate of HPV vaccination
Time Frame: Through 12 months post training (total estimated time: 12 months 3 days)

Rate of HPV vaccination will be assessed through vaccination records.
Through 12 months post training (total estimated time: 12 months 3 days)
Tertiary Care Cohort: Acceptability measured as Acceptability of Intervention Measure (AIM) score
Time Frame: At time of post-session survey completion on day 3 (total estimated time: 1 day)

AIM will be assessed by implementation champions' response to the 4 items of the AIM measure on the follow up survey. AIM is 5-point Likert scale question measured as follows: 1-Completely disagree, 2-Disagree, 3-Neither agree nor Disagree, 4-Agree, or 5-Completely agree. A higher score indicates greater acceptability. Scores above 3.0 are typically viewed as favorable/positive.
At time of post-session survey completion on day 3 (total estimated time: 1 day)
Tertiary Care Cohort: Appropriateness measured as Intervention Appropriateness Measure (IAM) score
Time Frame: At time of post-session survey completion on day 3 (total estimated time: 1 day)

IAM will be assessed by implementation champions' response to 4 items from the IAM measure on the follow up survey. IAM is measured by a 5-point Likert scale: 1-Completely disagree, 2-Disagree, 3-Neither agree nor Disagree, 4-Agree, or 5-Completely agree. A higher score indicates greater appropriateness of the intervention. Scores above 3.0 are typically viewed as favorable/positive.
At time of post-session survey completion on day 3 (total estimated time: 1 day)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Washington University School of Medicine

Collaborators

National Cancer Institute (NCI)

Investigators

  • Principal Investigator: Michelle Silver, PhD, ScM, Washington University School of Medicine
  • Principal Investigator: Jean Hunleth, PhD, MPH, Washington University School of Medicine

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

December 1, 2026

Primary Completion (Estimated)

August 31, 2027

Study Completion (Estimated)

August 31, 2027

Study Registration Dates

First Submitted

November 6, 2026

First Submitted That Met QC Criteria

November 6, 2026

First Posted (Actual)

November 13, 2026

Study Record Updates

Last Update Posted (Actual)

November 13, 2026

Last Update Submitted That Met QC Criteria

November 6, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 202211001
  • U01CA275033 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Deidentified individual participant data that support publication findings will be shared upon request following publication. Requests for any additional data must include a proposal for use of the requested data.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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