Improving retention and HIV viral load suppression among adolescents living with HIV in TASO Soroti and TASO Mbale centers of excellence using Operation Triple Zero model: a before and after study protocol

Implementation Science Communications · 8 authors, 4 centres

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TL;DR

This is a study protocol for a before-and-after investigation to adapt and implement the Operation Triple Zero (OTZ) model in two Ugandan clinics. The central aim is to test if the model can improve retention in care and HIV viral load suppression among adolescents living with HIV.

Full summary

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This paper outlines a protocol for a before-and-after study to adapt and implement the Operation Triple Zero (OTZ) model in two Ugandan HIV centers of excellence. The study aims to improve primary outcomes of retention in care and HIV viral load suppression among adolescents living with HIV. The methodology includes a mixed-methods design using secondary data, focus group discussions, and key informant interviews to identify barriers and facilitators. Implementation will be guided by the Consolidated Framework for Implementation Research (CFIR) and Knowledge to Action (K2A) frameworks, and evaluated using the RE-AIM framework. A paired t-test is planned to compare means of retention and viral load suppression before and after the intervention. Key stated limitations include potential timeframe inadequacy, changes in official viral load suppression definitions, and the introduction of other concurrent interventions.

STUDY TYPE

other

SPECIALTY

pediatrics

SUMMARISED BY

AI pipeline

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ORIGINAL PAPER

PMC10259809

Improving retention and HIV viral load suppression among adolescents living with HIV in TASO Soroti and TASO Mbale centers of excellence using Operation Triple Zero model: a before and after study protocol

Implementation Science Communications

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ABSTRACT

Abstract Background Retention in care and HIV viral load suppression remains sub-optimal among HIV positive adolescents in many settings including TASO Uganda, despite the implementation of interventions such as regimen optimization and community-based approaches like multi-month drug dispensing. To this end, the implementation of additional intervention is urgently required to address gaps in current programming which include inadequate centralization of the HIV positive adolescents and their caregivers in the designs. This study, thus, proposes to adapt and implement the Operation Triple Zero (OTZ) model in TASO Soroti and Mbale centers to improve both retention and viral load suppression among the adolescents living with HIV. Methodology A before and after study design is preferred, employing both qualitative and quantitative approaches. To identify barriers and facilitators to retention and HIV viral load suppression among the HIV positive adolescents, secondary data, focused group discussions, and key informant interviews will be used to understand perspectives of the adolescents, their caregivers, and the health-workers. The Consolidated Framework for Implementation Research (CFIR) will help in designing the intervention, while Knowledge to Action (K2A) will support the adaptation process. To test the intervention, Reach, Effectiveness, Adaption, Implementation and Maintenance (RE-AIM) framework will be used. A paired t -test will be used to compare means of retention and viral load suppression in the before and after study periods. Discussion This study aims at adapting and implementing the OTZ model in TASO Soroti and Mbale Centers of Excellence (COEs) to attain optimal retention and HIV viral load suppression rates among the HIV positive adolescents in care. Uganda is yet to adapt the touted OTZ model and findings from this study will be important in providing the necessary lessons to inform a policy shift for potential scale up of the model. Furthermore, results of this study could provide additional evidence for the effectiveness of OTZ in attaining optimal HIV treatment outcomes among the adolescents living with HIV. Keywords: HIV, Adolescents, OTZ, Viral load, Retention

CITATION EXPORT

Bonniface Oryokot, Andrew Kazibwe, David Kagimu et al.. Improving retention and HIV viral load suppression among adolescents living with HIV in TASO Soroti and TASO Mbale centers of excellence using Operation Triple Zero model: a before and after study protocol. Implementation Science Communications. (2023). https://doi.org/10.1186/s43058-023-00449-9

AUTHORS

8 · 4 CENTRES

Bonniface Oryokot, Andrew Kazibwe, David Kagimu, Abraham Ignatius Oluka, Darlius Kato, Yunus Miya, Michael Bernard Etukoit, Eleanor Namusoke-Magongo

1The AIDS Support Organization (TASO) Uganda, Kampala, Uganda
2University of Suffolk, Ipswich, UK
3Makerere University College of Health Sciences, Kampala, Uganda
4AIDS Control Program, Ministry of Health, Kampala, Uganda