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

摘要 这一行政补充要求提供资金，为光盘参与者提供病毒载量分析，以优化 使用阶梯式工具，并保留将病毒抑制作为结果的随机对照试验设计。我们的数据- 知情分级护理(DISC)干预将肯尼亚艾滋病毒护理中的青少年和年轻人(AYA)分配到 根据需要采取不同的卫生服务强度。将Aya分配到特定的服务、医疗保健 工人们使用风险评估工具来识别需要加强护理的阿亚。他们还认为阿亚在 艾滋病毒护理需要不那么密集的服务，以使方案能够适当分配有限的资源。 不幸的是，肯尼亚的病毒载量供应有限，导致一年多来没有病毒载量分析。 对于许多Aya艾滋病毒护理客户来说，这是一年。我们请求预算支持，以支付参与的病毒载量分析 AYA在两点上：在登记进入试验时通知步骤分配和在退出时病毒的次要结果 压制。这将对干预的有效性和机制提供重要的见解 有效，并将为DISCRCT增加重要的价值。科学目标没有改变。

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.