Scale-up of an Evidence-based Adolescent Transition Package to Support Transitional Care Among Youth Living With HIV

What this Trial Is About

This research aims to improve care for youth living with HIV in Kenya by scaling up an evidence-based Adolescent Transition Package (ATP). The study evaluates how well a youth-led, data-driven implementation strategy (ATP-YES) supports the transition from pediatric to adult HIV care compared to the standard of care. It focuses on improving youth readiness to transition, viral suppression, retention in care, and overall health outcomes using a cluster randomized controlled trial design involving 32 clinics across four counties. The study compares two approaches: standard of care implementation using a trainer of trainers (ToT) method and an enhanced ATP-YES strategy that includes youth-led data audits, feedback, and collaborative learning cycles. Existing healthcare workers at clinics will deliver the ATP during routine visits over a 36-month intervention period. Youth aged 10-24 will be offered the ATP, with those aged 15-24 invited to participate in surveys and focus groups. Clinics are randomized 1:1 to either intervention or control arms. Participants will be involved in surveys, focus groups, and routine medical record reviews. Healthcare workers will provide feedback through interviews and continuous quality improvement activities. The study tracks outcomes such as ATP reach, adoption by providers, fidelity of implementation, viral suppression, retention, and transition readiness over 42 months. Costs and budget impacts of the ATP-YES strategy will also be evaluated. The project includes youth advisory boards and collaboration with Kenyan health authorities to ensure alignment with national priorities.

Scale-up of an Evidence-based Adolescent Transition Package to Support Transitional Care Among Youth Living With HIV