Oryokot Bonniface, Kazibwe Andrew, Kagimu David, Oluka Abraham Ignatius, Kato Darlius, Miya Yunus, Etukoit Michael Bernard, Namusoke-Magongo Eleanor
The AIDS Support Organization (TASO) Uganda, Kampala, Uganda.
University of Suffolk, Ipswich, UK.
Implement Sci Commun. 2023 Jun 12;4(1):65. doi: 10.1186/s43058-023-00449-9.
Retention in care and HIV viral load suppression remains sub-optimal among HIV positive adolescents in many settings including TASO Uganda, despite the implementation of interventions such as regimen optimization and community-based approaches like multi-month drug dispensing. To this end, the implementation of additional intervention is urgently required to address gaps in current programming which include inadequate centralization of the HIV positive adolescents and their caregivers in the designs. This study, thus, proposes to adapt and implement the Operation Triple Zero (OTZ) model in TASO Soroti and Mbale centers to improve both retention and viral load suppression among the adolescents living with HIV.
A before and after study design is preferred, employing both qualitative and quantitative approaches. To identify barriers and facilitators to retention and HIV viral load suppression among the HIV positive adolescents, secondary data, focused group discussions, and key informant interviews will be used to understand perspectives of the adolescents, their caregivers, and the health-workers. The Consolidated Framework for Implementation Research (CFIR) will help in designing the intervention, while Knowledge to Action (K2A) will support the adaptation process. To test the intervention, Reach, Effectiveness, Adaption, Implementation and Maintenance (RE-AIM) framework will be used. A paired t-test will be used to compare means of retention and viral load suppression in the before and after study periods.
This study aims at adapting and implementing the OTZ model in TASO Soroti and Mbale Centers of Excellence (COEs) to attain optimal retention and HIV viral load suppression rates among the HIV positive adolescents in care. Uganda is yet to adapt the touted OTZ model and findings from this study will be important in providing the necessary lessons to inform a policy shift for potential scale up of the model. Furthermore, results of this study could provide additional evidence for the effectiveness of OTZ in attaining optimal HIV treatment outcomes among the adolescents living with HIV.
在包括乌干达艾滋病支持组织（TASO）在内的许多地区，尽管实施了诸如优化治疗方案和多月份药物分发等基于社区的方法等干预措施，但艾滋病毒阳性青少年的治疗留存率和艾滋病毒病毒载量抑制情况仍未达到最佳水平。为此，迫切需要实施额外的干预措施，以弥补当前项目中的差距，这些差距包括在设计中艾滋病毒阳性青少年及其照顾者的集中化不足。因此，本研究提议在TASO索罗蒂和姆巴莱中心采用并实施“零艾滋病毒母婴传播、零儿童新发感染、零青少年死亡”（OTZ）模式，以提高艾滋病毒感染青少年的治疗留存率和病毒载量抑制率。
首选采用前后对照研究设计，同时运用定性和定量方法。为了确定艾滋病毒阳性青少年治疗留存和艾滋病毒病毒载量抑制的障碍及促进因素，将使用二手数据、焦点小组讨论和关键信息访谈来了解青少年、他们的照顾者以及卫生工作者的观点。实施研究综合框架（CFIR）将有助于设计干预措施，而知识转化为行动（K2A）将支持适应过程。为了测试干预措施，将使用覆盖范围、有效性、适应性、实施和维持（RE-AIM）框架。将使用配对t检验来比较研究前后阶段治疗留存率和病毒载量抑制率的均值。
本研究旨在在TASO索罗蒂和姆巴莱卓越中心（COEs）采用并实施OTZ模式，以在接受治疗的艾滋病毒阳性青少年中实现最佳的治疗留存率和艾滋病毒病毒载量抑制率。乌干达尚未采用备受推崇的OTZ模式，本研究的结果对于提供必要的经验教训以推动政策转变从而可能扩大该模式的规模具有重要意义。此外，本研究的结果可为OTZ在实现艾滋病毒感染青少年最佳治疗结果方面的有效性提供更多证据。
