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Alliance Sustainability Projects

To further enhance the quality of HIV prevention and health care for adolescents through implementation science, AHISA supports small collaborative contracts with the goal of catalyzing long-term and sustainable region-/country-specific collaborations that respond to local implementation issues and increase implementation science capacity across the region.

Eligibility is limited to current AHISA members.

Local HIV Implementation Science Alliances

African Youth Implementation Science Alliance
Location: East and South Africa
Years: 2021, 2019
Led by: Kawango Agot, Impact Research Institute

The African Youth Implementation Science Alliance (AYISA) is anchored on the Reducing HIV in Adolescents and Youth Conference and its 30-under-30 initiative where young people under 30 years old submitted concept proposals on reducing HIV among youth ages 15-24 years in Eastern and Southern Africa. The concepts were competitively selected by youth and experts. The 30 winners were mentored by senior researchers to develop their concepts into full protocols and obtain ethics and other regulatory approvals and awarded seed funding to pilot their projects (anticipated to end Dec 2022). The 30 winners are the founding members of AYISA. Currently, the 30 winners are being trained on the basics of implementation science and collecting implementation data as part of their pilot work.

Central and West Africa Implementation Science Alliance
Location: Central and West Africa
Years: 2020, 2019
Led by: Nadia Sam-Agudu, Institute of Human Virology, Nigeria

The Central and West Africa Implementation Science Alliance (CAWISA) is a regionally-focused consortium of senior researchers and postdoctoral mentees in multidisciplinary biomedical and behavioral research. CAWISA aims to build durable local implementation science capacity to address major public health issues in West and Central Africa, including adolescent HIV. The five-point sustainability plan includes the following: 1) Leadership and Vision; 2) Scholars and Mentors: engaging individuals committed to scientific advancements, diligent in scholarship and integrity, and willing to continuously pay it forward; 3) Strategic Partnerships; 4) Research Productivity and Impact and 5) Sustained Funding.

Kenya Adolescent HIV Implementation Science Alliance
Location: Kenya
Years: 2021, 2020, 2019
Led by: Juddy Wachira, Moi University (2021), Edith Apondi, Moi Teaching and Referral Hospital (2019-2021)

The Kenya Adolescent HIV Implementation Science Alliance (KAHISA) aims to build capacity for implementation science among stakeholders working in the field of adolescent and young adult HIV in Kenya. KAHISA is training 20 program implementers in five high HIV burden counties in Kenya on implementation science. KAHISA is leveraging resources available in Kenya to train and support small grant implementation science work in these counties including the Kenyatta National Hospital online training platform, the University of Nairobi trainees, and the ACQUIRE Quality Improvement training platform, which aims to promote evidence-guided quality improvement for frontline health workers and institutions. ACQUIRE used the quality improvement framework to introduce implementation science to the trainees. The trainees will then pick thematic quality improvement areas in their workplaces to address using implementation science study methodology, and will be supported to develop proposals for, and subsequently implement in their workplace settings under supervision.

South African Adolescent HIV Implementation Science Alliance
Location: South Africa
Years: 2021, 2020, 2019
Led by: Moherndran Archary, University of KwaZulu-Natal (2019); Brian Zanoni, Emory University (2020)

The South African Adolescent HIV Implementation Science Alliance (AHI(SA)2) is a group of key stakeholders involved in adolescent HIV care, treatment, prevention and research in South Africa. The goals are to exchange ideas, identify challenges and create creative solutions to implementing interventions along the continuum of prevention and treatment of HIV among adolescents. They aim to work with youth to create approaches to implementation science and work together toward collaborative solutions.

Tanzanian Adolescent HIV Prevention and Treatment Implementation Science Alliance
Location: Tanzania
Years: 2021, 2020
Led by: Dorothy Dow, Duke University Medical Center

The Tanzanian Adolescent HIV Prevention and Treatment Implementation Science Alliance (T-AHISA) goals are to formally establish a sustainable network of key Tanzanian stakeholders (e.g., researchers, implementors, policy makers, and youth advocates) engaged in adolescent HIV-focused research and programs in Tanzania; to develop an implementation science research agenda with the Tanzanian government to help tackle the most pressing challenges leveraging the robust in-country network; and to build capacity for implementation science research by mentoring early stage investigators with paired mentors from the alliance. The inaugural meeting was held November 2021 and focused on the importance of adolescent mental health in HIV prevention and treatment. Mentee-mentor adolescent HIV implementation science research dyads and broader East-Africa research “pods” are in development.

Uganda Adolescent HIV Prevention and Treatment Implementation Science Alliance
Location: Uganda
Years: 2021, 2020, 2019
Led by: Moses Kamya, Makerere University and Infectious Diseases Research Collaboration & Fred Semitala, Makerere University

The Uganda Adolescent HIV Prevention and Treatment Implementation Science Alliance (U-AHISA) was established in 2019 to promote the use of evidence-based interventions to deliver HIV services to adolescents and young people in Uganda by bringing together officials from government ministries, academia, youth, and HIV implementing programs. After being trained on implementation science core principles and how it related to the gaps along the continuum of HIV services, these stakeholders have worked in small, thematic groups, including tuberculosis, mental health, Antiretroviral Therapy (ART) & Viral Suppression, Determining the Effectiveness of Dispensing Messages study, and HIV testing services, to identify gaps, develop interventions to address those gaps, mentor HIV-positive adolescents, organize didactic lectures, and develop implementation science research agendas that are used to apply for research funding. One group (ART & Viral Suppression) successfully received funding to study the fidelity of health care providers to intensified adherence counselling for caregivers of HIV-infected children with non-suppressed viral load at three health centers in rural Uganda. Looking forward, U-AHISA will establish smaller, regional implementation science alliances among regional hospitals and promote the use of evidence-based interventions in the delivery of HIV services for adolescents living with HIV.

Zambia Adolescent HIV Prevention and Treatment Implementation Science Alliance
Location: Zambia
Years: 2021, 2020, 2019
Led by: Michael Mbizvo, Population Council, Zambia

Population Council in Zambia, after mapping organizations involved in adolescent HIV implementation science, created the Zambia Adolescent HIV Prevention and Treatment Implementation Science Alliance (ZAHISA) as a local platform for sharing related research activities and findings. The alliance has been invaluable in their efforts to work with adolescents and strengthening implementation science research capacity for HIV prevention and care, identify barriers to accessing services, and participate in research. ZAHISA has further ensured youth engagement through their participation in the ZAHISA Advisory Committee, which is chaired by a Director in the Ministry of Health. Currently, ZAHISA is building on the success of the preceding two-year relationship with AHISA by collating and documenting lessons, challenges and success stories, and establishing preferences for addressing stigma and discrimination associated with access and utilization of HIV testing and treatment services and research among adolescents and young adults.


Youth Engagement

Pangea Zimbabwe AIDS Trust
Location: Zimbabwe
Year: 2021
Led by: Marguerita Lightfoot, Oregon Health & Science University – Portland State University

The Pangea Zimbabwe AIDS Trust (PZAT) AHISA project aims to increase youth engagement in implementation science research by developing a training and toolkit of developmentally appropriate materials that will increase the capacity and understanding of youth in the implementation science research process, terminology, and designs. The training approach is based on the prior work and expertise of PZAT. At the conclusion of the training, there will be a cadre of youth who are prepared to engage in and contribute to implementation science research and be deployed in local implementation science projects. The training will build the knowledge, competency, and ability of youth to be a meaningful partner in implementation science research.

Ushiriki wa Vijana: Youth Engagement to end the HIV epidemic in Tanzania (in collaboration with T-AHISA)
Location: Tanzania
Year: 2021
Led by: Dorothy Dow, Duke University Medical Center

Engaging youth as central partners, beneficiaries, and leaders is critical to ending the HIV epidemic. This project is establishing and supporting formal youth community advisory boards (CAB) in four study regions of Tanzania (Kilimanjaro, Mwanza, Mbeya, and Ifakara) in which the Sauti ya Vijana (The Voice of Youth) study is active. Youth CABs complete a concept mapping exercise to identify the most critical factors that impact the implementation of HIV-related prevention and treatment programs for young people in Tanzania from the youth perspective. The elected chair of each youth CAB will be invited to present at the T-AHISA meeting and will travel to other key youth leaders’ events. Giving youth an opportunity to be engaged in meaningful ways by incorporating their voice as beneficiaries, partners, and community leaders will ultimately result in improved health outcomes within the HIV epidemic in Tanzania.

VOICE: HIV Open Call on Informed Consent and Ethics in Research Involving Young People
Location: Nigeria
Year: 2021
Led by: Oliver Ezechi, Emory University

The purpose of the VOICE summit, which will take place on December 7-9th, 2022 in Lagos, Nigeria, is to convene a diverse group of adolescent and young adult stakeholders to finalize a consensus statement on informed consent of adolescent and young adult in HIV research studies in low- and middle-income countries (LMICs). The consensus group will bring together an exceptional group of adolescent and young adult, HIV researchers, advocates, policy experts, and stakeholders from across LMICs. The team’s evidence review on this topic can be found here and a description of the related PATC3H US NIH network is here.

YES! Youth Engaging for Success: a peer mentoring program for adolescents and young adults to improve viral suppression
Location: Zambia
Year: 2021
Led by: Sam Miti, Arthur Davidson Children’s Hospital

This project aims to build the capacity of HIV infected youth peer mentors and other youth leaders to lead the scale-up of “Project YES! Youth Engaging for Success” to improve health outcomes among adolescents and young adults living with HIV in Zambia. Project YES! is an HIV clinic-based peer mentoring program that was conducted among youth living with HIV in four HIV clinics in Ndola, Zambia to improve adherence to antiretroviral therapy, decrease internalized HIV stigma, and improve viral suppression. This AHISA-sponsored project is focused on scaling-up this Centers for Disease Control and Prevention (CDC) compendium, evidence-based intervention and supports the development of a youth task team that lead several youth-led stakeholder meetings to gain information on next steps for the scale-up process. Through this process, the youth task team, with guidance from members of the regional Zambia AHISA network, will outline their scale-up approach using implementation science principles that will be given to the Ministry of Health and be used for a funding proposal.


Building Towards Sustainability

Adolescent Transition to Adult Care for HIV-infected Adolescents
Location: Kenya
Year: 2021
Led by: Irene Njuguna, Kenyatta National Hospital

The Adolescent Transition to Adult Care for HIV-infected Adolescents (ATTACH) project assesses the sustainability of a new evidence-based adolescent transition package intervention to improve transition readiness among adolescents living with HIV in Kenya, which demonstrated effectiveness in real world settings. To ensure future scalability and sustainability, the adolescent transition package was adapted to suit local needs in terms of who, when, and how it is delivered. The project explores sustaining the intervention in clinics that participated in the original clinical trial and adopting it at control sites that received training for intervention implementation post trial. In addition, the project will engage stakeholders to develop plans for intervention scale-up at a national level.

Adolescents in Research Toolkit
Location: Sub-Saharan Africa
Year: 2019
Led by: Linda-Gail Bekker, Desmond Tutu HIV Foundation

The Adolescents in Research toolkit (AIRT) was created as an online resource to provide guidance to a wide variety of stakeholders who design, implement, and disseminate adolescent health research and implementation science projects. Launched in June 2022, the toolkit is an online comprehensive clinical, logical, ethical-legal resource to facilitate the safe and effective involvement of adolescents in the implementation of health and other related research in sub-Saharan Africa. As the website states, “anyone working with adolescents in research, or implementing adolescent research, regardless of your experience in research or where you are on the research journey will benefit from this toolkit.”

The Implementation Science Training Program for Adolescent HIV Implementation Research
Location: Nigeria
Year: 2020
Led by: Kehinde Kuti, University of Ibadan, Nigeria

The Implementation Science Training Program builds capacity in Nigerian investigators for Adolescent HIV Implementation Research (iTRAIN) through a 12- month, online mentored training program. The project developed a highly interactive online implementation research curriculum designed to build the implementation research capacity of about 40 clinician investigators and implementers involved in an NIH-funded multi-center adolescent HIV grant (Intensive Combination Approach to Roll Back the Epidemic in Nigerian Adolescents - iCARE Nigeria). iTRAIN utilizes a facilitator-led, asynchronous-synchronous model to deliver this curriculum through an online implementation research course followed by synchronous virtual sessions and mentoring to develop a project embedded into iCARE Nigeria. iTRAIN also has fostered regional AHISA group collaborations and sustainability through engagement with another AHISA member, Nadia-Sam Agudu (PI, CAWISA) as a facilitator and mentor.

Using Implementation Science Research to Link Stakeholders and Vulnerable AGYW in Tanzania with HIV prevention and livelihood training
Location: Tanzania
Year: 2021
Led by: Thespina (Nina) Yamanis, American University

This project uses implementation science to monitor barriers and facilitators to program scale-up of a combined cash plus (livelihood and entrepreneurship training, cash transfer and mentoring) and social norms HIV prevention intervention, Msichana Salama, to out-of-school adolescent girls and young women (AGYW) in Dar es Salaam, Tanzania. In addition, the project maps out stakeholders who provide livelihood skills training, entrepreneurship training, or financial support to adolescent girls and young women. After mapping, the project creates a platform that will link these stakeholders with out-of-school AGYW.


Adaption to COVID

Adolescent HIV Care During COVID-19 Pandemic
Location: Kenya
Year: 2020
Led by: Kristin Beima-Sofie, University of Washington

The objective of this project is to understand implementation of an adolescent transition package adapted to mobile phone delivery in response to the COVID-19 pandemic within an ongoing clinical trial. The project evaluated healthcare worker adaptations and key influences on the acceptability and feasibility of implementation with the goal of identifying strategies that optimized implementation and maximized impact.

Implementation Science research to inform HIV prevention and care programming across adolescents in Zambia in light of the COVID-19 Pandemic (in collaboration with ZAHISA)
Location: Zambia
Year: 2020
Led by: Michael Mbizvo, Population Council

In 2021 ZAHISA, convened a series of cascade workshops with key informants, including young people living with HIV, community opinion leaders and health care providers, to elicit information on preferences and lived experiences, related to research participation and information and services on HIV prevention and care, in the wake of the COVID-19 pandemic and its related restrictions. This included HIV testing services, antiretroviral treatment, and sexual and reproductive health services access. The series allowed for sharing information on barriers and enablers for continued access to HIV prevention and care, including participation in on-going implementation research projects. Information on promising interventions and programmatic approaches was also shared at the December 2021 national adolescent health symposium.

Implementation Science Research to reach Out-of-School, AGYW with HIV Prevention & Livelihood Training
Location: Tanzania
Year: 2020
Led by: Thespina (Nina) Yamanis, American University

This project explored how the COVID-19 pandemic affected the livelihoods, health, and HIV risk behaviors of a cohort of out-of-school AGYW in Dar es Salaam, Tanzania. An in-person survey using COVID-safe measures was conducted to examine financial security, mental health, HIV testing, transactional sex, and condom use. An increase in depression symptoms and experiences of intimate partner violence due to factors related to the pandemic led to using in-depth interviews to explore how/if the participants were able to sustain their livelihood skills during the pandemic. Key informants who provided health services to AGYW in Dar Es Salaam were also interviewed about the potential for scaling-up services to reach more AGYW who are out of school. Action plans will be developed with each of these informants in order to explore strategies for scale-up. Findings will then be disseminated to stakeholders to help them develop action plans to extend their programs’ reach to out-of-school AGYW.

Pre-exposure Prophylaxis – Adolescent Girls and Young Women
Location: South Africa
Year: 2020
Led by: Makhosazane Khoza, Wits University

COVID-19 prompted adaptations to current pre-exposure prophylaxis (PrEP) delivery to facilitate PrEP persistence. This project explored the acceptability of remote PrEP delivery among AGYW in South Africa from 2021-2022. We found that remote PrEP delivery is feasible and acceptable for AGYW, especially for those with limited time or access to facilities. However, they may not appeal to all AGYW, particularly those who lived in confined spaces and had not disclosed PrEP use. These findings support de-medicalising PrEP services through remote delivery and increasing access to PrEP for AGYW, irrespective of the COVID-19 pandemic status. Programmes will need to focus on overcoming barriers to remote delivery, particularly around self-testing in this age group.