Family Connections randomized controlled trial: assessing the feasibility and acceptability of an intervention with adolescents living with HIV and their caregivers in Ndola, Zambia

ABSTRACT

Achieving the 95-95-95 UNAIDS targets requires meeting the needs of adolescents, however we lack evidenced-based approaches to improving adolescent adherence to antiretroviral therapy (ART), increasing viral suppression, and supporting general wellbeing. We developed Family Connections as a group intervention for adolescents and their adult caregivers and conducted a randomized controlled trial in Ndola, Zambia to test feasibility and acceptability. Fifty pairs (n = 100) of adolescents (15–19 years and on ART ≥ 6 months) and their caregivers were randomly assigned either to the intervention consisting of 10 group sessions over 6 months, or to a comparison group, which received the usual care. Each pair completed baseline and endline surveys, with adolescents also undergoing viral load testing. Of the 24-intervention adolescent/caregiver pairs, 88% attended at least eight group sessions. Most adolescents (96%) and all caregivers would recommend Family Connections to peers. Adolescent viral failure decreased but did not significantly differ by study group. Adolescents in the intervention group showed a greater reduction in HIV-related feelings of worthlessness and shame than the comparison group. The feasibility, acceptability, and the positive trend toward significantly reducing internalized stigma, generated by this Family Connections pilot study, contributes valuable data to support adolescent/caregiver approaches that use peer groups.

KEYWORDS:

• Adolescents
• HIV care continuum
• stigma
• viral suppression
• Africa
• adherence

Disclosure statement

No potential conflict of interest was reported by the author(s).

Geolocation information

This study was conducted in Ndola, Zambia.

Data availability statement

We did not obtain assent/consent from participants to make their data available to a third party, therefore we are not able to make the data publicly available. Rather our consent forms specified the following “the study research team will have access to your data. This team includes the study investigators, research assistants and data analysts. All data collected from you will be destroyed in 3 years after the end of the study”.

Additional information

Funding

This work was supported by the National Institute of Mental Health (NIMH) under grant 1R34MH105264-01; and The Johns Hopkins University Center for AIDS Research, an NIH-funded program under grant P30AI094189, which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH,NIA, FIC, NIGMS, NIDDK, and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.