Innovative Approach to Decentralizing HIV Care in Peru Using Tele-education and Quality Improvement

What this Trial Is About

This research aims to understand how HIV care is decentralized in Peru to improve retention in care and viral suppression among people with HIV. Decentralizing HIV services is an important strategy that has not been widely studied with experimental designs, especially in urban areas. This study will provide valuable insights for future efforts to decentralize HIV treatment both in Peru and other countries. The study uses a step-wedge design to assess how decentralized HIV services are adopted and expanded across primary health clinics PHCs in Peru over 54 months. A behavioral intervention combining NIATx Network for the Improvement of Addiction Treatment with Project ECHO tele-education connects secondary health centers SHCs and PHCs in a hub and spoke model. The intervention is rolled out in phases including control, active NIATxECHO training, and maintenance periods to support guideline-based decentralization. Participants include clinicians and leaders working at PHCs and SHCs involved in HIV care. Researchers will evaluate the percentage of people with HIV treated in PHCs, retention in care, and viral suppression rates over the study period. The study also monitors how well clinics adopt the intervention and follow decentralization guidelines. The total observation lasts up to 54 months, with assessments to understand barriers and facilitators to decentralized HIV care.

Peru Decentralized HIV Care