Social support to retain adolescents living with HIV in care and improve ART adherence

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ABSTRACT Career Goal: I am committed to a career as a behavioral health scientist, integrating psychological science with public health. My goal is to develop interventions that improve outcomes among adolescents living with HIV (ALWH) globally. Career Development: This career development award will enhance my analytical skills and provide specific training in social network analysis, and intervention development, testing, and evaluation. In this application, I seek to: 1) gain proficiency in the use of social network analysis to inform intervention development; 2) gain essential skills to develop an interactive, network-based, social support intervention to retain ALWH in HIV care and improve ART adherence; 3) obtain the training needed to use preliminary data gathered from this proposal to support a follow up grant proposal for a larger trial aimed at evaluating the proposed intervention. Research Project: Compared to other age groups, South African ALWH are least adherent to medication regimens, resulting in elevated rates of HIV-related morbidity, mortality, medication resistance, and HIV transmission. To improve the outcomes of ALWH, we must identify innovative and engaging methods to retain them in HIV care. The overall goal of the proposed study is to advance knowledge on the role of ALWHs’ social networks in their treatment-related outcomes and develop a network-based, social support intervention to retain them in HIV care and increase ART adherence. First, I will conduct an egocentric social network analysis of ALWH to determine how key members of their social networks influence their retention in HIV care and ART adherence. Next, I will conduct qualitative analysis using data from ALWH and their network members to identify best practices to facilitate intervention acceptability and feasibility. Then, I will use participatory methods to adapt two network-based interventions to fit the target population and increase their retention in HIV care and ART adherence. Lastly, I will conduct a pilot study in Cape Town, South Africa to evaluate the intervention. Mentorship: I will work with a highly accomplished, multidisciplinary team of experts who will support me over the course of the proposed project. My mentors are Drs. John Bartlett (Duke University), Michael Sweat (MUSC Center for Global Health), Linda-Gail Bekker (Desmond Tutu HIV Centre, University of Cape Town), Michael Relf (Duke University), and Carl Latkin (Johns Hopkins Bloomberg School of Public Health) and my advisors are Drs. Audrey Pettifor (UNC) and Joseph Tucker (UNC). Future Directions. This award will also inform future NIH grant applications (R34 and R01) to optimize and evaluate the intervention in a larger study sample.