Mobile Phone–Based Intervention Among Adolescents Living With Perinatally Acquired HIV Transitioning from Pediatric to Adult Care: Protocol for the Interactive Transition Support for Adolescents Living With HIV using Social Media (InTSHA) Study

Abstract

Background Adolescents living with perinatally acquired HIV often have poor retention in care and viral suppression during the transition from pediatric to adult-based care. Objective The aim of this study is to evaluate a mobile phone–based intervention, Interactive Transition Support for Adolescents Living With HIV using Social Media (InTSHA), among adolescents living with perinatally acquired HIV as they transition from pediatric to adult care in South Africa. Methods InTSHA uses encrypted, closed group chats delivered via WhatsApp (Meta Platforms Inc) to develop peer support and improve communication between adolescents, their caregivers, and health care providers. The intervention is based on formative work with adolescents, caregivers, and health care providers and builds on several existing adolescent support programs as well as the Social-ecological Model of Adolescent and Young Adult Readiness for Transition (SMART). The final InTSHA intervention involves 10 modules conducted weekly through moderated WhatsApp group chats with adolescents and separately with their caregivers. We will randomly assign 80 South African adolescents living with perinatally acquired HIV who are aware of their HIV status and aged between 15 and 19 years to receive either the intervention (n=40) or standard of care (n=40). Results We will measure acceptability of the intervention as the primary outcome and evaluate feasibility and preliminary effectiveness for retention in care and viral suppression after completion of the intervention and at least 6 months after randomization. In addition, we will measure secondary outcomes evaluating the impact of the InTSHA intervention on peer support, self-esteem, depression, stigma, sexual education, connection to health care providers, and transition readiness. Enrollment began on April 15, 2021. As of December 31, 2021 a total of 78 out of expected 80 participants have been enrolled. Conclusions If successful, the intervention will be evaluated in a fully powered randomized controlled trial with a larger number of adolescents from urban and rural populations to further evaluate the generalizability of InTSHA. Trial Registration ClinicalTrials.gov NCT03624413; https://clinicaltrials.gov/ct2/show/NCT03624413 International Registered Report Identifier (IRRID) DERR1-10.2196/35455

Internet-based peer support interventions for people living with HIV: A scoping review

“…The majority of articled revised were studies conducted in the United States (12) [ 77 , 80 – 82 , 84 , 88 , 90 , 94 , 95 , 99 , 100 , 104 ], three were from Kenya [ 86 , 92 , 102 ] and three from South Africa [ 85 , 93 , 101 ]. Locations like China, the United Kingdom and Zambia had two studies included in this review [ 79 , 87 , 91 , 96 , 98 , 103 ] and, from the total of articles included, only one article was from Malaysia, Nigeria, Tanzania and Uganda [ 78 , 83 , 89 , 97 ].…”

“…Regarding the study type, eight of the included articles corresponded to pilot studies [ 77 , 79 , 86 , 88 , 92 , 101 , 102 , 104 ], while seven articles explicitly indicate a clinical trial type of design [ 83 , 85 , 86 , 90 , 95 , 96 , 98 ], as well as five protocols [ 80 – 82 , 93 , 94 ] and five qualitative studies [ 87 , 91 , 99 , 100 , 103 ]. Only two Randomized Controlled Trials [ 78 , 97 ], and one cohort study [ 89 ].…”

“We Should Be Taught Self-Respect, Self-Confidence and Self-Love”: Youth Perspectives of Adult Influences on Their Sexuality and Relationships Among South African Adolescents Living With HIV

“…This theoretical framework provides practical insight into interventions likely to be effective with this group, simultaneously engaging youth and impactful adults in their support networks (10), and illustrating specific recommendations for mapping onto existing intervention approaches. Specifically, these interventions could take the form of mHealth or in-person interventions with parallel programming to simultaneously engage ALHIV, caregivers, and clinicians, targeting all levels of the socio-ecological framework (41,50,51,(53)(54)(55)(56). There is also a need for future interventions to focus on positive parenting around sexuality, integrated HIV and mental healthcare, communication and decision-making skillbuilding, and socially acceptable health education to encourage healthy sexual decision-making in ALHIV.…”

“I am not shy anymore”: A Qualitative Study of the Impact of an Interactive mHealth Intervention on Sexual Health Knowledge, Attitudes, and Behaviors of South African Adolescents with Perinatal HIV

“…The facilitators also ran a separate group chat for the caregivers of the participants which addressed the same material each week. Full information about InTSHA can be found in the intervention protocol (24).…”