Meet the CIPHER grantees
||The HIV Netherlands Australia Thailand Research Collaboration
||Associate Professor Stephen Kerr
Sirinya Teeraananchai is a biostatistician at HIVNAT and works on several projects for the TREAT Asia paediatric network. She analyses data from Thai National AIDS Program (NAP) database to evaluate interventions for adults and children, and is the lead biostatistician on a project studying the natural history of HPV in adolescents living with perinatally acquired HIV in Asia.
More information on Sirinya | Email
“Using real-world data from the NAP, I will work to understand how to improve service delivery, programme and treatment outcomes, using a model that, if successful, can be emulated by other research groups. The CIPHER grant is an incredible opportunity to improve the health of adolescents and youth living with HIV.”
Research project: Evaluation of service delivery to improve the HIV treatment cascade among HIV-infected youth in Thailand
Increasing numbers of youth, mostly from marginalized key populations, are acquiring HIV. In Asia, Thailand is a leader in HIV treatment. It uses a centralized electronic health record through the NAP. Most new patients living with HIV are aged 15-24 years and numbers are increasing: 7,218 were diagnosed in 2017, up from 2,995 in 2013. Dr Teeraananchai’s group analysed a dataset of 10,000 youth living with HIV aged 15-24 years in Thailand from 2008 to 2013 treated under the NAP. It found that 11% were lost to follow up and only 57% had an HIV-RNA test within a year of initiating treatment. This points to an urgent need to improve the treatment cascade in youth, both for better health status and to limit transmission among this population.
The CIPHER project
The objectives of this study are to:
- Describe linkage from HIV diagnosis along the treatment cascade in youth living with HIV aged 15-24 years from 2008 to 2013 and from 2014 to 2018 after treatment guidelines were changed to start ART at any CD4 count.
- Compare treatment cascade outcomes within the NAP system across service delivery models with such characteristics as HIV clinic size, youth as a proportion of the total number of patients, and whether the hospital provides youth-focused clinics.
- Assess how service delivery, in terms of improvements along the cascade, changes after an intervention designed to improve performance has been implemented. This part will be done through a consortium of 10 HIV clinics in a Bangkok area with a high number of youth clients.
Outcomes will be re-assessed after six months. The ultimate goal is to highlight areas for improvement in service delivery to youth living with HIV throughout Thailand in order to achieve the UNAIDS 90-90-90 targets.