Title The Peer Support Intervention - supporting HIV positive adolescents in Zimbabwe to improve HIV care continuum outcomes~Short Title The Peer Support Intervention~Study Design Prospective randomized study~Study Duration 2 years~Study Population 250 Youth (ages 10-24 years) with virologic failure~Study Outcomes Primary Outcomes~1. Virologic suppression rate in the The Peer Support Intervention group compared with the standard of care group following 48 weeks in the Peer Support Intervention.~Secondary Outcomes~Frequency of acquired drug resistance mutations among youth failing ART.~Baseline prevalence of psychological distress among adolescents and young adults failing first line therapy~Prevalence of psychological distress (measured using PHQ-A and SSQ) after 48 weeks of enrolment in the Peer Support Intervention compared with the standard of care~Association between self-reported adherence, pill counts and objective surrogate markers of adherence obtained from plasma (viral load), DBS and hair (tenofovir concentrations).~Effectiveness of point mutation assays for the detection of drug resistance as compared with standard sequencing techniques.~Description of Intervention Youth with evidence of virologic failure defined as an HIV VL>400 copies/mL on two consecutive occasions at least 1 month apart will be eligible for enrollment. Youth will be randomized to a community based peer counseling support group or clinic based standard of care, with viral load, and drug monitoring evaluations at 3 month intervals to determine the efficacy of the intervention in improving adherence and virologic suppression.~Study Sites Parirenyatwa Hospital Family Care Centre
Youth with evidence of virologic failure defined as an HIV VL>400 copies/mL on two consecutive occasions at least 1 month apart will be eligible for enrollment. Youth will be randomized to a community based peer counseling support group or clinic based standard of care, with viral load, and drug monitoring evaluations at 3 month intervals to determine the efficacy of the intervention in improving adherence and virologic suppression.