Despite the substantial declines in HIV transmission and increases in lifespan among those living with HIV achieved over the past decade, full benefits that should be possible based on the tools and interventions currently available have yet to be realized in youth, in large part because efficacious interventions for this age group have not been brought to scale. To be effective, youth must be fully engaged in interventions at every stage of the HIV care (treatment and prevention) cascades: HIV testing, linkage to care, timely initiation of care, persistence and adherence to antiretroviral care. At-risk HIV-negative youth need to be consistently engaged in prevention strategies such as PEP and/or PrEP as indicated, consistent safer sex practices and repeat HIV testing.
This U19 project - Scale It Up - specifically focuses on the process of improving self-management among youth including: 1) the identification of interventions that are efficacious and effective for improving self-management in YLH and at risk youth; 2) the multi-site implementation of an intervention shown to be efficacious in improving self-management; and 3) the assessment of the Five Components of Self- Management Model and how these vary over time, are directly improved by interventions, and mediate intervention effects.
Scale It Up is composed of three Cores.
- Management Core
The Management Core includes a Clinical Site Management Center (CMSC) which coordinates activities across 11 adolescent HIV clinics across the United States involved in Scale It Up protocols; and a Recruitment and Enrollment Center (REC) which coordinates protocol/project management, recruitment/retention, and data management for all Scale It Up protocols. The Management Core also provides coordination and support across and within the U19s.
- Analytic Core
The Analytic Core coordinates all quantitative analyses (formative research and RCT analyses) for Scale It Up protocols, as well as analyses of EMR data provided by the 11 clinical sites in order to address HIV care cascade monitoring. In addition, the Analytical Core implements and carries out cost effectiveness data collection and analysis for all the protocols, and provides training and mentorship to junior investigators around analytic techniques and approaches.
- Implementation Science Core
The Implementation Science Core supports the protocols with core qualitative and quantitative measures of fidelity and intervention fit, and monitors adaptations during implementation. They develop and provide standardized facilitator training, and develop strategies for dissemination of effective interventions. In addition, this Core oversees qualitative data collection and analyses for the Scale It Up U19.
Current and upcoming Scale It Up studies can be found here.