Adolescent Trials Network for HIV-AIDS Scale It Up Program: Protocol for a Rational and Overview.

Area of Science:

• Implementation Science
• Public Health
• Adolescent Health

Background:

• Significant progress in HIV/AIDS prevention and treatment has been made, yet youth living with HIV receive antiretroviral therapy less often than adults.
• Health disparities persist, with young men of color who have sex with men disproportionately affected by HIV.
• Efficacious interventions exist but are not fully implemented in real-world settings, hindering optimal outcomes for youth.

Purpose of the Study:

• To describe the structure of the U19-SIU initiative and its effectiveness-implementation hybrid trials.
• To outline center-wide protocols and initiatives within SIU aimed at improving HIV prevention and care for youth.
• To advance implementation science and self-management science in the context of youth HIV.

Main Methods:

• SIU employs 4 individual primary protocols, 2 center-wide protocols, and 3 cross-project initiatives.
• Effectiveness-implementation hybrid designs are utilized in the primary protocols.
• Implementation scales assessing inner and outer context factors will be applied across protocols.

Main Results:

• The SIU initiative was funded by the National Institute for Child Health and Human Development and commenced in October 2016.
• As of November 2018, six SIU protocols had initiated their first phase of work.
• Details of specific trials such as SMART, YMHP, TMI, EPIS, Cascade Monitoring, and We Test are available in associated publications.

Conclusions:

• The youth HIV research portfolio has historically underemphasized self-management.
• SIU protocols and initiatives directly address this by evaluating self-management interventions for effectiveness and implementation.
• SIU innovations include an expanded self-management framework, hybrid trial designs, cost-effectiveness analyses, implementation scale application, and analysis of provider-patient interactions.