AYANI is a nested cohort of sites within global IeDEA that have been equipped to recruit adolescents and youth living with HIV (ALWH) and perform in-depth data collection around factors that may influence HIV care outcomes, especially as ALWH transition to adulthood. This cohort of ALWH will be followed prospectively with the aim of characterizing the specific biological, mental, social, and cultural factors that make it difficult for ALWH to achieve viral suppression, maintain care engagement, and prevent onward HIV transmission especially as they transition to adulthood – and how these factors may vary for ALWH around the world.
Addressing site-level determinants of outcomes, individual-level determinants, and route of HIV transmission for adolescents, and using the rich prospective data collected from this cohort, AYANI aims to answer three key scientific questions:
- What is the impact of ALWH care transitions and availability of social support on medium- and long-term care engagement, adherence, and viral suppression among ALWH?
- What is the prevalence of mental health disorders, substance use, and traumatic experiences among ALWH over time?
- How does perinatal HIV acquisition impact sexual risk behaviors, fertility intentions and pregnancy?
AYANI was funded in February 2020 with an 18-month NICHD supplement to each of the six IeDEA pediatric regions (East Africa, Central Africa, West Africa, Southern Africa, Asia-Pacific, and Caribbean/Central and South America [CCASAnet]) to launch the pilot phase of the AYANI cohort. In the Central Africa IeDEA region, we have established the AYANI sites at two health centers in Rwanda, where we will enroll 100 ALWH between the ages of 15-24 years for AYANI baseline and follow-up assessments, including 60 with perinatally-acquired HIV.