Sare

Researchers are evaluating a youth-led, data-driven implementation strategy to expand an evidence-based Adolescent Transition Package (ATP) designed to improve the transition from pediatric to adult HIV care for youth living with HIV in Kenya. This study builds on a previous trial and aims to improve the number of youth receiving the ATP, provider adoption, and consistent use of the ATP over time. The study also assesses the cost-effectiveness of this implementation approach and its impact on health outcomes such as viral suppression and retention in care. The study will involve 32 HIV clinics randomized to either the standard of care implementation strategy (Trainer of Trainers) or an enhanced strategy called ATP-Youth Enhanced Strategy (ATP-YES), which adds youth-led data audits, feedback, and collaborative learning. The ATP is delivered by healthcare workers during routine clinic visits for youth aged 10 to 24 years. Older youth (15-24 years) will participate in surveys and focus groups, while healthcare workers will engage in surveys, interviews, and quality improvement activities throughout the 36-month study period. Participants will have their routine medical records reviewed, and healthcare workers and youth will provide feedback on implementation experiences. The study will measure outcomes including ATP reach, effectiveness on viral suppression and retention, adoption by healthcare workers, fidelity to ATP processes, and maintenance of the intervention. Costs and budget impact will also be examined over the 42 months from enrollment through 6 months after study end.