Meet the CIPHER grantees

Tongdiyen Laura Jasper

Year awarded: 2019
Institution: Institute of Human Virology Nigeria
Research site: Nigeria
Primary mentor: Nadia Sam-Agudu, Institute of Human Virology Nigeria

Tongdiyen Laura Jasper iis a public health physician and Quality Improvement Officer, Paediatric and Adolescent HIV, at the Institute of Human Virology Nigeria (IHVN). Dr Jasper co-led IHVN’s PEPFAR-funded Paediatric Quality Improvement Learning Collaborative, aimed at improving 90-90-90 benchmarks among children and adolescents.

More information on Tongdiyen | www.ihvnigeria.org | Email

“Healthcare workers have observed challenges with caregivers and HIV treatment compliance for children. This grant will evaluate the impact of structured caregiver support in improving medication adherence and viral suppression among children in Nigeria.”

Research project:The impact of structured caregiver peer support (CaPS) on ART adherence and viral suppression among children living with HIV in Nigeria: A randomized controlled trial, Nigeria

The issue

Adherence for children living with HIV is a by-proxy phenomenon dependent on caregivers (parents, relatives or unrelated guardians) who may or may not be living with HIV. The complexity of paediatric formulations and dosing for ART regimens often poses challenges for caregivers, making ART administration and achievement of viral suppression for young children quite a difficult task. Peer support for caregivers presents a potentially feasible and impactful approach to improve ART adherence and facilitate achievement of viral suppression among children. However, there is a scarcity of robust evidence on the impact of caregiver support as a treatment adherence strategy for children.

The CIPHER project

The study is a two-arm cluster randomized controlled trial that includes 132 unsuppressed children living with HIV (0-10 years old) and their caregivers at six cluster sites in Nigeria. It will:

  • Explore facilitators and barriers to ART adherence among young children to develop a caregiver peer mentor training curriculum and interventional programme.
  • Test the impact of caregiver peer support, a locally adapted behavioural intervention, to improve adherence and promote achievement of viral suppression among children.

The intervention will target caregivers of unsuppressed children, measuring outcomes at child level after six, 12 and 18 months of follow up. The intervention arm will receive structured caregiver-to-caregiver peer support while the control arm will receive routine standard of care with no such support. The researchers will compare viral suppression and ART drug-pickup rates for children living with HIV at specific time points for both arms.

The impact

The researchers expect findings to support the evidence base for formal integration of structured peer support into policy on HIV programmes and to help close the viral suppression gap between adult and paediatric populations. Dr Jasper and her team will leverage the Nigeria Implementation Science Alliance’s expansive platform to disseminate potentially impactful findings for timely policy change and scale up.

Dr Jasper and other young clinicians and researchers on the CaPS Nigeria team will benefit from capacity building through hands-on proposal development, project implementation, implementation science methods, qualitative research methods, data management and scientific reporting.