Improving Viral Load Suppression Among Men and Children Active in Care Through Community-Designed and Led Solutions: Protocol for Retrospective Closed Cohort Study in Eastern Uganda

In collaboration with facilities, communities, district local government, and the United States Agency for International Development (USAID) implementing partners, the iDARE methodology was implemented at the community level to address root causes of low HIV antiretroviral therapy adherence among me...

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Bibliographic Details
Published in:	JMIR research protocols Vol. 11; no. 4; p. e32784
Main Authors:	Odom, Krista J, Ottosson, Amanda, Draru, Joyce, Komujuni, Harriet, Karamagi Nkolo, Esther Karungi, Faramand, Taroub Harb
Format:	Journal Article
Language:	English
Published:	Canada JMIR Publications 13-04-2022
Subjects:	Antiretroviral agents Antiretroviral drugs Behavior modification Children Cohort analysis Community involvement Drug resistance Health surveillance HIV Human immunodeficiency virus Local government Males Mens health Morbidity Population Protocol Public health Social behavior Uganda HIV/AIDS viral load suppression behavioral science antiretroviral therapy social and behavior change AIDS USAID gender, youth, and social inclusion virus 95-95-95 community design HIV children men Uganda people living with HIV behavior change methodology implementation science
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Summary:	In collaboration with facilities, communities, district local government, and the United States Agency for International Development (USAID) implementing partners, the iDARE methodology was implemented at the community level to address root causes of low HIV antiretroviral therapy adherence among men and children actively enrolled in care, resulting in low viral load suppression (VLS) in two districts in the eastern region of Uganda. The methodology encourages the use of cocreated sustainable solutions addressing gender, youth, and social inclusion issues to reduce barriers to care and reach the 95-95-95 Joint United Nations Programme on HIV/AIDS target for HIV epidemic control. We aim to measure the impact of iDARE on VLS for men and children active in care and investigate the practical scale up of the solutions designed using the iDARE methodology. The primary objective of this study will be to measure the implementation impact of the iDARE methodology at the facility and community levels on VLS for people living with HIV. The secondary objective is to investigate the practical scale up of the iDARE methodology using evidence-based gender, youth, and social inclusion social behavior change packages to rapidly meet the Ugandan Ministry of Health targets for VLS. A retrospective cohort study design will be used to analyze program data that aims to increase the rates of VLS in men and children who are classified as active in care using community engagement and quality improvement techniques. We will examine 3 pilot health centers' data from a USAID-funded program aimed at social behavior change to increase health-seeking behavior in Uganda. Based on the iDARE process and results, change packages were developed to highlight lessons learned and best practices in order to share with subsequent implementation sites. The USAID-funded Social and Behavior Change Activity began implementation of iDARE in September 2020, with baseline data collected in August 2020. Data on viral load suppression was collected from facilities on a monthly basis to record progress toward the 95-95-95 goal. The expected primary outcome is an increase in actively enrolled men and children reaching VLS in order to meet the Ugandan Ministry of Health target of 95% VLS among those active in care. DERR1-10.2196/32784.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1929-0748 1929-0748
DOI:	10.2196/32784