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 HIV patients face enormous challenges in accessing HIV care services. Given their vulnerability to risk-taking behaviour, this group also have worse treatment outcomes compared to other age groups. Poor treatment outcomes will impact negatively on HIV/AIDS management and control particularly in sub–Saharan Africa (SSA) as more than 80% of global HIV–infected adolescents live in this region of the world. Limited evidence exists on the effectiveness of service delivery interventions to support adolescents’ linkage from HIV diagnosis to ART initiation, retention on antiretroviral therapy (ART) and adherence to ART. Objectives: This trial is designed to evaluate the impact of conditional economic incentives coupled with motivational interviewing on adolescents’ linkage, retention and adherence to ART and HIV care in Anambra State, south-east Nigeria. Methods: The study will be a cluster randomized, controlled trial conducted in selected HIV treatment hospitals in Anambra State, Nigeria. Based on sample size calculation, twelve HIV treatment hospitals from Anambra will be selected for the study. Six HIV treatment hospitals each will be randomized to either intervention or control arm. A structured adherence support scheme termed the “Incentive Scheme” will be applied to the intervention clinics while the control clinics will receive routine HIV care (usual care). Additionally, patients in the intervention arm will receive motivational interviewing at baseline and following initiation of ART, they will receive a gift voucher of Nigerian Naira (NGN) 2000 when viral load (VL) is <20 copies/mL at 12 weeks, gift voucher of NGN 1000 if the VL remains suppressed for the next 3 months, and the next 6 months, and finally gift voucher of NGN 2000 if the VL remains < 20 copies/mL at 1 year. All gift vouchers will be conditional not only on VL results but attending for motivational interviewing. The primary outcome for the trial will be difference between groups in the proportion with HIV viral load (VL) suppression (=20 copies/mL) by 12 months and then 24 months after withdrawal of incentive scheme. Overall impact: The findings of this proposed trial will provide evidence on feasibility of applying conditional economic incentives combined with motivational interviewing to improve retention and adherence to antiretroviral therapy of adolescents living with HIV in Nigeria and possibly other sub Saharan African countrries.
Network EDCTP2
Call Career Development Fellowships 2016

Project partner

Number Name Role Country
1 Nnamdi Azikwe University Coordinator Nigeria