The FANMI ("my FAMILY" in Creole) study to evaluate community-based cohort care for adolescent and young women living with HIV in Haiti: Protocol for a randomized controlled trial

Grace Seo, Joseph Marie Bajo Joseph, Nancy Confident, Esther Jean, Bianca Louis, Tatiana Bell, Rose Cardelle Riche, Marie Elmase Belizaire, Vanessa Rouzier, Alexandra Apollon, Lindsey Reif, Vanessa Rivera, Elaine Abrams, Heejung Bang, Bruce Schackman, Daniel Fitzgerald, Jean W. Pape, Margaret L. McNairy

Research output: Contribution to journalArticle

Abstract

Background: Adolescent girls and young women living with HIV in resource-limited settings have the poorest health outcomes of any age group, due in part to poor retention in care. Differentiated models of HIV care that target the specific challenges of young people living with HIV are urgently needed. Methods: The FANMI study is an unblinded randomized controlled trial designed to evaluate the efficacy of an adolescent-specific model of HIV care in Port-au-Prince, Haiti. The FANMI intervention places newly young women living with HIV who are not currently on ART or on ART ≤ 3 months, in cohorts of 5-10 peers to receive monthly group HIV care in a community location. In contrast, participants in the standard care arm receive routine HIV care and individual counseling each month in GHESKIO's Adolescent Clinic. A total of 160 participants ages 16-23 years old are being randomized on a 1:1 basis. The primary outcome is retention in HIV care defined as being alive and in care at 12 months after enrollment. Secondary outcomes include viral suppression at 12 months, sexual risk behaviors, acceptability of the FANMI intervention, and health care utilization and costs. Discussion: The FANMI study evaluates a novel community-based cohort model of HIV care aimed at improving retention in care and reducing risk behaviors for HIV transmission among adolescent girls and young women living with HIV. Specifically, the FANMI model of care addresses social isolation by placing participants in cohorts of 5-10 peers to provide intensified peer support and makes HIV health management a group norm; reduces stigma and improves convenience by providing care in a community setting; and integrates clinical care and social support by the same providers to streamline care and promote long-term patient-provider relationships. If shown to be effective, the FANMI intervention may serve as a model of HIV care for improving retention among hard-to-reach adolescents and young adults in Haiti and could be adapted for other high-risk groups globally.

Original languageEnglish (US)
Article number1749
JournalBMC Public Health
Volume19
Issue number1
DOIs
StatePublished - Dec 30 2019

Fingerprint

Haiti
Randomized Controlled Trials
HIV
Risk-Taking
Patient Acceptance of Health Care
Social Isolation
Health
Long-Term Care
Sexual Behavior
Social Support
Health Care Costs

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

The FANMI ("my FAMILY" in Creole) study to evaluate community-based cohort care for adolescent and young women living with HIV in Haiti : Protocol for a randomized controlled trial. / Seo, Grace; Joseph, Joseph Marie Bajo; Confident, Nancy; Jean, Esther; Louis, Bianca; Bell, Tatiana; Riche, Rose Cardelle; Belizaire, Marie Elmase; Rouzier, Vanessa; Apollon, Alexandra; Reif, Lindsey; Rivera, Vanessa; Abrams, Elaine; Bang, Heejung; Schackman, Bruce; Fitzgerald, Daniel; Pape, Jean W.; McNairy, Margaret L.

In: BMC Public Health, Vol. 19, No. 1, 1749, 30.12.2019.

Research output: Contribution to journalArticle

Seo, G, Joseph, JMB, Confident, N, Jean, E, Louis, B, Bell, T, Riche, RC, Belizaire, ME, Rouzier, V, Apollon, A, Reif, L, Rivera, V, Abrams, E, Bang, H, Schackman, B, Fitzgerald, D, Pape, JW & McNairy, ML 2019, 'The FANMI ("my FAMILY" in Creole) study to evaluate community-based cohort care for adolescent and young women living with HIV in Haiti: Protocol for a randomized controlled trial', BMC Public Health, vol. 19, no. 1, 1749. https://doi.org/10.1186/s12889-019-8065-6
Seo, Grace ; Joseph, Joseph Marie Bajo ; Confident, Nancy ; Jean, Esther ; Louis, Bianca ; Bell, Tatiana ; Riche, Rose Cardelle ; Belizaire, Marie Elmase ; Rouzier, Vanessa ; Apollon, Alexandra ; Reif, Lindsey ; Rivera, Vanessa ; Abrams, Elaine ; Bang, Heejung ; Schackman, Bruce ; Fitzgerald, Daniel ; Pape, Jean W. ; McNairy, Margaret L. / The FANMI ("my FAMILY" in Creole) study to evaluate community-based cohort care for adolescent and young women living with HIV in Haiti : Protocol for a randomized controlled trial. In: BMC Public Health. 2019 ; Vol. 19, No. 1.
@article{3d4dd9c6fb644bfe89f272653e2e7414,
title = "The FANMI ({"}my FAMILY{"} in Creole) study to evaluate community-based cohort care for adolescent and young women living with HIV in Haiti: Protocol for a randomized controlled trial",
abstract = "Background: Adolescent girls and young women living with HIV in resource-limited settings have the poorest health outcomes of any age group, due in part to poor retention in care. Differentiated models of HIV care that target the specific challenges of young people living with HIV are urgently needed. Methods: The FANMI study is an unblinded randomized controlled trial designed to evaluate the efficacy of an adolescent-specific model of HIV care in Port-au-Prince, Haiti. The FANMI intervention places newly young women living with HIV who are not currently on ART or on ART ≤ 3 months, in cohorts of 5-10 peers to receive monthly group HIV care in a community location. In contrast, participants in the standard care arm receive routine HIV care and individual counseling each month in GHESKIO's Adolescent Clinic. A total of 160 participants ages 16-23 years old are being randomized on a 1:1 basis. The primary outcome is retention in HIV care defined as being alive and in care at 12 months after enrollment. Secondary outcomes include viral suppression at 12 months, sexual risk behaviors, acceptability of the FANMI intervention, and health care utilization and costs. Discussion: The FANMI study evaluates a novel community-based cohort model of HIV care aimed at improving retention in care and reducing risk behaviors for HIV transmission among adolescent girls and young women living with HIV. Specifically, the FANMI model of care addresses social isolation by placing participants in cohorts of 5-10 peers to provide intensified peer support and makes HIV health management a group norm; reduces stigma and improves convenience by providing care in a community setting; and integrates clinical care and social support by the same providers to streamline care and promote long-term patient-provider relationships. If shown to be effective, the FANMI intervention may serve as a model of HIV care for improving retention among hard-to-reach adolescents and young adults in Haiti and could be adapted for other high-risk groups globally.",
author = "Grace Seo and Joseph, {Joseph Marie Bajo} and Nancy Confident and Esther Jean and Bianca Louis and Tatiana Bell and Riche, {Rose Cardelle} and Belizaire, {Marie Elmase} and Vanessa Rouzier and Alexandra Apollon and Lindsey Reif and Vanessa Rivera and Elaine Abrams and Heejung Bang and Bruce Schackman and Daniel Fitzgerald and Pape, {Jean W.} and McNairy, {Margaret L.}",
year = "2019",
month = "12",
day = "30",
doi = "10.1186/s12889-019-8065-6",
language = "English (US)",
volume = "19",
journal = "BMC Public Health",
issn = "1471-2458",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - The FANMI ("my FAMILY" in Creole) study to evaluate community-based cohort care for adolescent and young women living with HIV in Haiti

T2 - Protocol for a randomized controlled trial

AU - Seo, Grace

AU - Joseph, Joseph Marie Bajo

AU - Confident, Nancy

AU - Jean, Esther

AU - Louis, Bianca

AU - Bell, Tatiana

AU - Riche, Rose Cardelle

AU - Belizaire, Marie Elmase

AU - Rouzier, Vanessa

AU - Apollon, Alexandra

AU - Reif, Lindsey

AU - Rivera, Vanessa

AU - Abrams, Elaine

AU - Bang, Heejung

AU - Schackman, Bruce

AU - Fitzgerald, Daniel

AU - Pape, Jean W.

AU - McNairy, Margaret L.

PY - 2019/12/30

Y1 - 2019/12/30

N2 - Background: Adolescent girls and young women living with HIV in resource-limited settings have the poorest health outcomes of any age group, due in part to poor retention in care. Differentiated models of HIV care that target the specific challenges of young people living with HIV are urgently needed. Methods: The FANMI study is an unblinded randomized controlled trial designed to evaluate the efficacy of an adolescent-specific model of HIV care in Port-au-Prince, Haiti. The FANMI intervention places newly young women living with HIV who are not currently on ART or on ART ≤ 3 months, in cohorts of 5-10 peers to receive monthly group HIV care in a community location. In contrast, participants in the standard care arm receive routine HIV care and individual counseling each month in GHESKIO's Adolescent Clinic. A total of 160 participants ages 16-23 years old are being randomized on a 1:1 basis. The primary outcome is retention in HIV care defined as being alive and in care at 12 months after enrollment. Secondary outcomes include viral suppression at 12 months, sexual risk behaviors, acceptability of the FANMI intervention, and health care utilization and costs. Discussion: The FANMI study evaluates a novel community-based cohort model of HIV care aimed at improving retention in care and reducing risk behaviors for HIV transmission among adolescent girls and young women living with HIV. Specifically, the FANMI model of care addresses social isolation by placing participants in cohorts of 5-10 peers to provide intensified peer support and makes HIV health management a group norm; reduces stigma and improves convenience by providing care in a community setting; and integrates clinical care and social support by the same providers to streamline care and promote long-term patient-provider relationships. If shown to be effective, the FANMI intervention may serve as a model of HIV care for improving retention among hard-to-reach adolescents and young adults in Haiti and could be adapted for other high-risk groups globally.

AB - Background: Adolescent girls and young women living with HIV in resource-limited settings have the poorest health outcomes of any age group, due in part to poor retention in care. Differentiated models of HIV care that target the specific challenges of young people living with HIV are urgently needed. Methods: The FANMI study is an unblinded randomized controlled trial designed to evaluate the efficacy of an adolescent-specific model of HIV care in Port-au-Prince, Haiti. The FANMI intervention places newly young women living with HIV who are not currently on ART or on ART ≤ 3 months, in cohorts of 5-10 peers to receive monthly group HIV care in a community location. In contrast, participants in the standard care arm receive routine HIV care and individual counseling each month in GHESKIO's Adolescent Clinic. A total of 160 participants ages 16-23 years old are being randomized on a 1:1 basis. The primary outcome is retention in HIV care defined as being alive and in care at 12 months after enrollment. Secondary outcomes include viral suppression at 12 months, sexual risk behaviors, acceptability of the FANMI intervention, and health care utilization and costs. Discussion: The FANMI study evaluates a novel community-based cohort model of HIV care aimed at improving retention in care and reducing risk behaviors for HIV transmission among adolescent girls and young women living with HIV. Specifically, the FANMI model of care addresses social isolation by placing participants in cohorts of 5-10 peers to provide intensified peer support and makes HIV health management a group norm; reduces stigma and improves convenience by providing care in a community setting; and integrates clinical care and social support by the same providers to streamline care and promote long-term patient-provider relationships. If shown to be effective, the FANMI intervention may serve as a model of HIV care for improving retention among hard-to-reach adolescents and young adults in Haiti and could be adapted for other high-risk groups globally.

UR - http://www.scopus.com/inward/record.url?scp=85077326528&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85077326528&partnerID=8YFLogxK

U2 - 10.1186/s12889-019-8065-6

DO - 10.1186/s12889-019-8065-6

M3 - Article

C2 - 31888569

AN - SCOPUS:85077326528

VL - 19

JO - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

IS - 1

M1 - 1749

ER -