Mobile Phone-Based Intervention Among Adolescents Living With Perinatally Acquired HIV Transitioning from Pediatric to Adult Care: Protocol for the Interactive Transition Support for Adolescents Living With HIV using Social Media (InTSHA) Study

Brian C Zanoni, Moherndran Archary, Thobekile Sibaya, Madeleine Goldstein, Scarlett Bergam, David Denton, Vincente Cordero, Cynthia Peng, Christina Psaros, Vincent C Marconi, Jessica E Haberer, Brian C Zanoni, Moherndran Archary, Thobekile Sibaya, Madeleine Goldstein, Scarlett Bergam, David Denton, Vincente Cordero, Cynthia Peng, Christina Psaros, Vincent C Marconi, Jessica E Haberer

Abstract

Background: Adolescents living with perinatally acquired HIV often have poor retention in care and viral suppression during the transition from pediatric to adult-based care.

Objective: The aim of this study is to evaluate a mobile phone-based intervention, Interactive Transition Support for Adolescents Living With HIV using Social Media (InTSHA), among adolescents living with perinatally acquired HIV as they transition from pediatric to adult care in South Africa.

Methods: InTSHA uses encrypted, closed group chats delivered via WhatsApp (Meta Platforms Inc) to develop peer support and improve communication between adolescents, their caregivers, and health care providers. The intervention is based on formative work with adolescents, caregivers, and health care providers and builds on several existing adolescent support programs as well as the Social-ecological Model of Adolescent and Young Adult Readiness for Transition (SMART). The final InTSHA intervention involves 10 modules conducted weekly through moderated WhatsApp group chats with adolescents and separately with their caregivers. We will randomly assign 80 South African adolescents living with perinatally acquired HIV who are aware of their HIV status and aged between 15 and 19 years to receive either the intervention (n=40) or standard of care (n=40).

Results: We will measure acceptability of the intervention as the primary outcome and evaluate feasibility and preliminary effectiveness for retention in care and viral suppression after completion of the intervention and at least 6 months after randomization. In addition, we will measure secondary outcomes evaluating the impact of the InTSHA intervention on peer support, self-esteem, depression, stigma, sexual education, connection to health care providers, and transition readiness. Enrollment began on April 15, 2021. As of December 31, 2021 a total of 78 out of expected 80 participants have been enrolled.

Conclusions: If successful, the intervention will be evaluated in a fully powered randomized controlled trial with a larger number of adolescents from urban and rural populations to further evaluate the generalizability of InTSHA.

Trial registration: ClinicalTrials.gov NCT03624413; https://ichgcp.net/clinical-trials-registry/NCT03624413.

International registered report identifier (irrid): DERR1-10.2196/35455.

Keywords: HIV; InTSHA; Social media; South Africa; WhatsApp; adolescent; caregiver; health care provider; mHealth; protocol; support; transition support.

Conflict of interest statement

Conflicts of Interest: JEH reports consulting for Merck & Co Inc and owns stock in Natera Inc. VCM has received investigator-initiated research grants (awarded to their institution) and consultation fees (both unrelated to the current work) from Eli Lilly and Company, Bayer AG, Gilead Sciences Inc, and ViiV Healthcare Ltd. All other authors have no conflicts of interest relevant to this article to disclose.

©Brian C Zanoni, Moherndran Archary, Thobekile Sibaya, Madeleine Goldstein, Scarlett Bergam, David Denton, Vincente Cordero, Cynthia Peng, Christina Psaros, Vincent C Marconi, Jessica E Haberer. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 21.01.2022.

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