Denne side blev automatisk oversat, og nøjagtigheden af ​​oversættelsen er ikke garanteret. Der henvises til engelsk version for en kildetekst.

Integrating iSYV Within HIV Clinical Care for Youth Living With HIV in Tanzania

27. maj 2026 opdateret af: Duke University
Youth living with HIV (YLWH) experience mental health (MH) challenges that compromise their HIV care. Though the MH gap is well described, MH service delivery to YLWH is rare, especially in low resource settings. MH professionals are few and interventions tailored to the needs of this population are scarce. This project proposes a way to bridge the gap by streamlining the Sauti ya Vijana (SYV, The Voice of Youth) intervention redesigned to integrate into the differentiated HIV clinical care model in Tanzania. SYV is a peer-led, group-based treatment designed with and for YLWH to address their self-reported MH challenges and stressors living with HIV.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

SYV incorporates components of existing evidence-based models: Trauma Focused-Cognitive Behavioral Therapy, Interpersonal Psychotherapy, and Motivational Interviewing to address the needs youth described in formative interviews. Preliminary data indicates implementation success with estimated effects towards improved MH, antiretroviral therapy adherence, and a 10% greater increase in viral suppression in the intervention arm compared to standard of care. The central hypothesis here is that the new integrated "i" SYV will be acceptable, feasible, and effective to improve virologic suppression and improve retention in care. The mechanism of change is that improved MH leads to better medication adherence, viral suppression, and care engagement. The rationale is twofold: 1) Tanzania is planning to initiate MH screening in HIV clinical visits, but the MH treatment gap persists; 2) the iSYV stepped-care package could be an effective approach to support integrated MH care for YLWH. The central hypothesis will be tested in a hybrid type-2 effectiveness-implementation trial. The first aim will leverage the Fit to Context Framework, using an iterative Designing for Dissemination and Sustainability approach. Current SYV peer-group leaders with extensive experience delivering SYV will co-design the new iSYV package. The iSYV in-person sessions will be delivered by trained peer youth leaders and be aligned to the Tanzanian differentiated care model: stable youth (those fully suppressed) attend clinic every 6 months; and unstable youth (those with HIV RNA > 50 copies/mL) attend enhanced adherence counseling monthly. Youth with symptoms of MH difficulties on screening (PHQ9-depression, GAD7-anxiety, Trauma-related stress) will join the unstable group. To support engagement between visits, iSYV will explore use of a mHealth gamification strategy. The second aim includes a pilot and a four-arm cluster randomized trial. Two large implementing partners of PEPFAR clinics will support testing of the iSYV care package. The primary outcome is powered to show an increase in viral suppression (HIV RNA <50 copies/mL) in the unstable group and improved retention in care among the stable group. Change in MH is measured as a secondary outcome. The third aim will evaluate implementation determinants and outcomes, including acceptability, feasibility, fidelity, and cost informed by the Consolidated Framework for Implementation Research. The proposal is significant because it is expected to help address the MH gap for YLWH with implications for HIV care in Tanzania and other low income areas.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

5000

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

      • Moshi, Tanzania
        • Elizabeth Glaser Pediatric AIDS Foundation implementing partner sites in Tanzania
        • Ledende efterforsker:
          • Akwila Temu, MD, MMED

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Barn
  • Voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  1. youth living with HIV (YLWH) 15-24 years;
  2. have understanding of their HIV status;
  3. able to attend iSYV sessions if site is randomized to the intervention.

Exclusion Criteria:

  1. inability to provide informed consent/assent or participate meaningfully in the intervention due to cognitive impairment, psychosis, or other disability;
  2. enrollment in any other MH, stigma-related, or adherence intervention research study.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Støttende pleje
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: eSOC (enhanced Standard of Care)
Currently mental health screening is not part of routine care. Youth at all trial clinics who report moderate to severe symptoms will be referred for care within the local standard.
mental health screening and referral within the standard of care for moderate to severe symptoms
Eksperimentel: eSOC (enhanced Standard of Care) + iSYV (integrated Sauti ya Vijana or The voice of youth)
iSYV is an intervention that will be peer-led and group based in six monthly sessions.
mental health screening and referral within the standard of care for moderate to severe symptoms
Integrated "i"SYV is a streamlined version of the original intervention SYV that is adapted for integration into routine clinical care. The original SYV intervention included 10 group weekly sessions (2 incorporating caregivers) and 2 individual sessions with adaptation to fit without routine adolescent HIV care based on Tanzanian National HIV Guidelines for HIV care follow up visits.
Eksperimentel: eSOC (enhanced Standard of Care) + iSYV + mHealth (mobile Health)
mHealth will be an additional experimental intervention exploring the boosting effect of gamification of intervention content to boost participant knowledge and understanding of iSYV content
mental health screening and referral within the standard of care for moderate to severe symptoms
Integrated "i"SYV is a streamlined version of the original intervention SYV that is adapted for integration into routine clinical care. The original SYV intervention included 10 group weekly sessions (2 incorporating caregivers) and 2 individual sessions with adaptation to fit without routine adolescent HIV care based on Tanzanian National HIV Guidelines for HIV care follow up visits.
A gamified version of iSYV that can be played via SMS or Whatsapp messaging.
Eksperimentel: eSOC (enhanced Standard of Care) + mHealth (mobile Health)
mHealth is evaluated as a stand alone experimental intervention in this arm to evaluate if mHealth alone (without in person iSYV content) can improve mental health and/or HIV RNA outcomes.
mental health screening and referral within the standard of care for moderate to severe symptoms
A gamified version of iSYV that can be played via SMS or Whatsapp messaging.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
viral load
Tidsramme: at 6-months
HIV RNA <50 copies/mL considered suppression (per National guidelines)
at 6-months
retention in care
Tidsramme: at 6-months
clinical follow up as prescribed within 30 days of scheduled 6-month appointment
at 6-months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
changes in self-reported antiretroviral therapy (ART) regarding adherence
Tidsramme: 6-months, 12-months, 18-months
Self-reported adherence on a 3 question survey (Wilson) 0-100 range, higher scores indicate greater adherence
6-months, 12-months, 18-months
change in self-reported mental health difficulties related to depression
Tidsramme: 6-months, 12-months, 18-months
self-report of the Patient Health Questionnaire-9 (PHQ-9 ) range is 0-27, higher scores indicate greater depression
6-months, 12-months, 18-months
change in self-reported mental health difficulties related to anxiety
Tidsramme: 6-months, 12-months, 18-months
self-report on the Generalized Anxiety Disorder-7 (GAD-7) range 0-21 with higher scores indicating greater anxiety
6-months, 12-months, 18-months
change in HIV knowledge in the SOC+iSYV intervention arm compared to SOC arm at 6 month follow-up and at all timepoints in the intervention arm compared to SOC arm
Tidsramme: 6-months, 12-months, 18-months
self reported knowledge on the HIV-KQ18 (HIV Knowledge questionnaire 18) range 0-18. higher score indicates more HIV knowledge
6-months, 12-months, 18-months
viral load
Tidsramme: 12-months, 18-months as drawn per standard of care
HIV RNA
12-months, 18-months as drawn per standard of care
retention in care
Tidsramme: 12-months and 18-months
follow up in routine HIV care within 30 days of scheduled 12-month and 18-month appointments
12-months and 18-months
change in coping and self efficacy on the Coping and Self-Efficacy Scale (CSES)
Tidsramme: 6-months, 12-months, 18-months
self-reported, 13 questions with scale of 0 to 2 (range 0 to 26), where a higher number is a better outcome, more coping and self-efficacy
6-months, 12-months, 18-months
change in resilience on People Living with HIV (PLHIV) Resilience Scale
Tidsramme: 6-months, 12-months, 18-months
10 items, scale 0 to 2 (range 0 to 20), higher number means more resilience and a better outcome
6-months, 12-months, 18-months
SYV risk behaviors scale
Tidsramme: 6-months, 12-months, 18-months
5 items assessing sexual activity, number of sexual partners, condom use, consumption of alcohol, cocaine, heroin, or other substances. These are yes/no response with clarification of rate/amount. Higher numbers is higher risk.
6-months, 12-months, 18-months
interpersonal violence on the World Health Organization intimate partner violence (WHO IPV) scale
Tidsramme: 6-months, 12-months, 18-months
self report, 15 items with 0=no and 1-yes. More yes (higher scale) means more experience with IPV.
6-months, 12-months, 18-months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Dorothy Dow, MD, MSc, Duke Universtiy

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

10. januar 2027

Primær færdiggørelse (Anslået)

31. marts 2029

Studieafslutning (Anslået)

30. september 2030

Datoer for studieregistrering

Først indsendt

13. maj 2026

Først indsendt, der opfyldte QC-kriterier

27. maj 2026

Først opslået (Faktiske)

2. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

2. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

27. maj 2026

Sidst verificeret

1. marts 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • Pro00119752

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

de-identified data

IPD-delingstidsramme

at the conclusion of trial analysis

IPD-delingsadgangskriterier

Data sharing is critical to confirm findings, discover important new associations, and to test new ideas that impact health. Our core quantitative dataset will be archived in the National Institute of Mental Health (NIMH) Data Archive (NDA). To achieve this we will harmonize our data to NDA common data elements (CDE) as much as possible prior to data collection. We will follow the standard practices of the NDA for data uploads, submitting data biannually beginning in the second submission cycle following the Notice of Award. Data will be made publicly available in the data archive at the time of publication.

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • SAP
  • ANALYTIC_CODE

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .