Cambildge

Advances in HIV treatment have transformed HIV from a deadly disease into a manageable chronic condition, allowing children infected at birth to live longer and healthier lives with effective antiretroviral therapy. However, HIV-related stigma continues to pose challenges for people living with HIV, particularly adolescents, by affecting their health-seeking behavior, clinical outcomes, psychological wellbeing, and timely diagnosis. This study aims to evaluate whether a digital peer-support intervention can reduce internalized and anticipated HIV stigma among adolescents living with HIV in South Ethiopia, while also exploring effects on psychological wellbeing, retention in care, and viral load suppression. The study compares two approaches: a digital peer-support anti-HIV stigma intervention and the standard in-clinic in-person psychosocial peer support. Participants in the digital intervention remotely attend educational sessions facilitated by trained peer leaders via the Telegram messaging platform, receiving audiovisual content across 12 sessions organized into two modules over 16 weeks. Smartphones and internet data are provided to support participation. The control group receives routine monthly in-person peer support sessions at their care hospitals, involving discussions, playtime, and shared meals with healthcare provider supervision. Participants will be assessed from enrollment through the 16-week intervention period. Researchers will measure HIV-related stigma using a validated 12-item scale, along with psychological wellbeing via depression and anxiety questionnaires. Retention in care will be tracked by visit attendance over the preceding 12 months. These evaluations aim to determine the intervention's effect on stigma reduction and related health outcomes in adolescents living with HIV.

Researchers are evaluating the effect on newborn birthweight of switching from iron-folic acid supplementation (IFA) to multiple micronutrient supplementation (MMS) as part of routine antenatal care in Ethiopia. This program effectiveness study uses a cluster randomized trial design to compare the impact of MMS versus IFA on birthweight. The study addresses recommendations from the World Health Organization to assess MMS in real-world settings and aims to inform the Ethiopian Ministry of Health about the benefits and feasibility of MMS implementation in multiple districts. The trial involves 42 districts randomized to either continue IFA supplementation or switch to MMS, which contains 15 essential vitamins and minerals including iron. The program started in March 2022, with birthweight data collected continuously from January 2023 to December 2024 using digital scales in health facilities. Facility surveys assessing process, costs, acceptability, and adherence will be conducted at baseline, midline, and endline, with additional interviews planned to explore implementation challenges. Participants include women aged 15 to 49 who deliver liveborn infants in enrolled health facilities. Data collection focuses on birthweight measured as part of routine maternity care. Secondary measures include the cost and cost-effectiveness of MMS, adherence rates, acceptability to women and providers, and implementation fidelity. The total study duration is 42 months, with final analysis expected in April 2025.