Approach Psychosocial study (WP3)

To gain insight in the psychosocial effects of PoC-VL monitoring on children and adolescents living with HIV and their caregivers (objective 4), we will execute a formative research phase, an action research phase and a proof-of-concept research phase. The formative research phase takes place in the four countries before PoC VL implementation. We will contextualize and psychometrically validate standardized surveys to measure participant pre-testing of stress, depression, feelings of hopelessness, anxiety, willingness to participate, knowledge on and attitudes towards PoC VL testing; and participant post-test screening of acceptance, preference, and satisfaction (20–22). We will also use qualitative research techniques to capture health provider satisfaction and ownership, ‘best existing practices’, and stigma. To carry out all the formative research phase activities in time, we will review the existing literature to inform us on a large number of indicators that we should be looking at. 

Action research phase will take place in the intervention sites in the four countries, taking a co-creation approach, we will develop and psychometrically validate a youth-friendly screening tool for child/adolescent and caregiver predictive of future issues like retention in care and drug adherence; and we will develop and test micro-interventions to facilitate and motivate engagement in PoC-VL testing. Task 2a: develop a screening tool; and task 2b: develop and pilot-test micro-interventions) will be initiated before the formative phase is finalized. The proof-of-concept phase will integrate the screening tool and micro-interventions in clinical care routine in one intervention site per country. We will collect user satisfaction data of health professional, child/adolescent and caregiver prior and post to the introduction of the innovations. We will validate the screening tool against its predictive power for future poor quality of life, retainment in care, ART adherence and viral suppression; and we will measure the impact of the screening tool and the micro-interventions on user and provider satisfaction, retention in care, drug adherence, and viral suppression. Task 3: Proof-of-concept work’ to be done in the four WP3 implementing sites (one site per country).