Data-informed Stepped Care (DiSC) to Improve Adolescent HIV Outcomes

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ABSTRACT This administrative supplement requests funds to provide viral load assays for DiSC participants to optimize utility of stepped tool and to retain cluster a RCT design that includes viral suppression as an outcome. Our data- informed stepped care (DiSC) intervention assigns adolescents and young adults (AYA) in HIV care in Kenya to different intensities of health services according to their need. To assign AYA to specific services, health care workers use a risk assessment tool to identify AYA needing intensified care. They also identify AYA thriving in HIV care needing less intensive services to enable programs to appropriately allocate limited resources. Unfortunately, viral load supplies have been limited in Kenya resulting in absence of viral load assays for over a year for many AYA HIV care clients. We request budgetary support to cover viral load assays for participating AYA at two points: at enrollment into the trial to inform step allocation and at exit for secondary outcome of viral suppression. This will provide important insights on the effectiveness of the intervention and mechanisms of effectiveness and will add important value to the DiSC RCT. Scientific aims are unchanged.