Adolescent transition to adult care for HIV-infected adolescents in Kenya (ATTACH): study protocol for a hybrid effectiveness-implementation cluster randomised trial.

摘要: Introduction Successfully transitioning adolescents to adult HIV care is critical for optimising outcomes. Disclosure of status, a prerequisite transition, remains suboptimal in sub-Saharan Africa. Few interventions have addressed both disclosure and transition. An adolescent transition package (ATP) that combines tools could support improve Methods analysis In this hybrid type 1 effectiveness-implementation cluster randomised controlled trial, 10 clinics with an estimated ≥100 young adults age 10–24 living (ALWHIV) Kenya will be implement the ATP compared receiving standard care. The includes provider assist Healthcare providers at intervention receive training on use adapt it through continuous quality improvement cycles over initial 6 months study, continued implementation 1 year. primary outcome readiness among ALWHIV ages 15–24 years, assessed monthly using 22-item score. Secondary outcomes including retention viral suppression end period (month 18), (acceptability, feasibility, fidelity, coverage penetration) programme costs complement effectiveness intent treat, mixed-effects linear regression models compare scores (overall by domain (HIV literacy, self-management, communication, support)) time control sites adjustment multiple testing, accounting clustering clinic repeated assessments. We estimate coefficients 95% CIs two- sided α=0.05. Ethics dissemination study was approved University Washington Institutional Review Board Kenyatta National Hospital Research Committee. Study results shared participating facilities, county national policy-makers. Trials registration number NCT03574129; Pre-results.