Project: Conditional economic incentives and motivational interviewing to improve adolescents’ retention and adherence to antiretroviral therapy in south-east Nigeria: a cluster randomised trial

Acronym	ARA - Adolescents’ Retention and Adherence Trial (Reference Number: TMA2016CDF-1548)
Duration	01/06/2018 - 30/11/2020
Project Topic	Adolescent Retention and Adherence Trial (ARA Trial) aims to improve the retention in care and adherence to antiretroviral therapy of HIV positive adolescents. Poor retention-in-care and poor adherence to therapy increases viral load, worsens disease and increases the chances of transmission of HIV. This has huge health implications in sub-Saharan Africa that bears about 90% of the global adolescent HIV population. There are few service delivery interventions in the literature that have been applied to solve the above mentioned issue. ARA trial proposes an incentive scheme to solve the poor retention in care and adherence to antiretroviral therapy by adolescents living with HIV. The incentive scheme comprises a cash incentive conditioned on meeting viral load target coupled to motivational interviewing. The incentive scheme aims to keep adolescents with HIV in care and improve their adherence to antiretroviral therapy. Conditional cash incentive has the capacity to increase demand for care and adherence to therapy immediately especially since financial reward could be obtained as target is achieved. Motivational interviewing on the other hand will help to sustain the demand for care and adherence to therapy since it helps bring about long lasting character change. Since ARA trial inception, we have successfully set up a cluster randomised trial in 12 HIV treatment hospitals in Anambra State. We work with 36 health personnel in the trial (3 per HIV treatment hospital). Additionally, I have 3 collaborators namely a research assistant (PhD candidate), a laboratory technologist (in-charge of the central viral laboratory) and a mentor. The trial successfully recruited 251 HIV adolescents (126 HIV adolescents in intervention arm and 125 HIV adolescents in control arm). The trial is in its seventh month as at June 2019. The principal investigator (PI) successfully undertook and passed 9 clinical trial short courses offered by The Global Health Network. We published one scientific publication (the research protocol) in “Trials”. We have also presented two abstracts at two conferences. The first is the preliminary work before the trials presented in 13th INTEREST conference at Accra, Ghana. The second is the trial protocol presented at the 9th EDCTP Forum in Lisbon, Portugal. ARA trial has helped to boost the clinical research capacity of health personnel in selected HIV treatment hospitals in Anambra State. The participants’ benefit from increased viral load testing (typically done annually) which invariably helps in better monitoring. For more information on ARA trial, visit http://www.ebhc-unizik.com/
Network	EDCTP2
Call	Career Development Fellowships 2016

Project partner

Number	Name	Role	Country
1	Nnamdi Azikwe University	Coordinator	Niger