Kagera

This research aims to improve care for pregnant and postpartum adolescent girls and young women (AGYW) aged 15-24 years living with HIV in Tanzania, focusing on preventing HIV transmission to their babies and enhancing treatment retention and health outcomes. The study addresses how often young women attend health appointments and stay on treatment up to two years after birth, infant HIV-free survival, timing of subsequent pregnancies, and social factors influencing care engagement. It involves four sub-studies including data analysis, evidence review, co-creation of interventions, and a cluster-randomized trial. The study includes analyzing health records from 559 health facilities for AGYW who started HIV prevention services between 2018 and 2020, conducting interviews to understand challenges, and working with participants to develop a tailored package of interventions. The intervention package, which may include peer mentor mothers, partner involvement, flexible clinic hours, and mobile reminders, will be tested in a pilot trial involving trained focal teams at selected facilities. The trial will compare intervention and standard care to assess effects on retention, viral load, and infant outcomes. Participants will provide health data through routine records, take part in interviews and focus groups, and engage in co-design workshops. Outcomes measured include time to antiretroviral therapy (ART) attrition, viral load detectability, and HIV-free infant survival over 24 months. The study also monitors repeat pregnancies and service uptake, uses qualitative feedback, and assesses intervention delivery fidelity. Participation spans from retrospective data analysis to a one-year follow-up after intervention delivery, ensuring comprehensive evaluation of care improvements for AGYW with HIV.