Continuum is designed to inform the design of a future transitional HIV care intervention for persons recently released from prison (i.e., “releasees”) by examining longitudinal clinical outcomes and post-release retention in care among formerly incarcerated people living with HIV in Lusaka, Zambia.

• Prospectively assess clinical outcomes for incarcerated people living with HIV following release;
• Explore factors from health behavior theory that are associated with post-release retention in care, with a special focus on Alcohol Use Disorders (AUDs); and
• Conduct formative research to determine releasee and stakeholder knowledge, attitudes, and preferences surrounding transitional care interventions.

Results from this study are expected in late 2020.

In collaboration with the CIDRZ TB Unit and Zambia National TB Program, Empirix aims to evaluate the effect of Xpert MTB/RIF on patient health outcomes and empirical TB diagnosis and treatment practice in a “real-world,” outpatient clinical setting.

• i. Determine the effects of Xpert on HIV-positive presumptive TB patient health outcomes.
• Evaluate the effects of Xpert on the accuracy of health workers’ empirical TB diagnosis and treatment practices.

REACHZ aims to accelerate Zambia’s ongoing efforts to achieve 95-95-95 targets and reach epidemic control by integrating new technology (i.e. rapid point-of-care recency testing) within highly targeted testing modalities to identify individuals and active clusters of transmission contributing to propagation of new HIV infections. Specifically, the study aims to:

• Describe the effects of recency-enhanced index testing on overall facility-level HIV testing yield and linkage to care.
• Characterize the index testing cascade reached before and after introducing the Asante Point of Care (POC) assay to enhance this testing modality, including the number of new positives identified.
• Offer recency testing as part of ongoing routinely available index testing at approximately 2 high-volume, public health facilities in Lusaka Urban District (under the auspices of the CDC/PEPFAR programs, CIDRZ ACHIEVE and University of Maryland at Baltimore (UMB)/ CIDRZ CIRKUITS).

This study will not only help guide Zambia’s HIV case-finding efforts, but also inform better targeting of ART among newly diagnosed PLHIV and pre-exposure prophylaxis (PrEP) among HIV-negative persons in high-risk networks.

Improving adolescent girls’ access and uptake of available sexual and reproductive health (SRH) services, including prevention services, HIV testing, care and treatment requires concrete and innovative efforts. To increase adolescent girls’ awareness and utilization of available SRH services, Grassroot Soccer (GRS) is has developed two football based interventions, known as SKILLZ, targeting school aged girls. 1) a curriculum previously used in schools and 2) a new “enhanced” package which provides greater interaction with SRH prevention methods).

The SKILLZ study aims to assess the impact of the new enhanced intervention amongst adolescent school girls (regardless of their HIV status) over two years on:

1. HIV testing and subsequent retention in care, and

2. Contraceptive uptake and continuation for pregnancy prevention

The study will be conducted across several high density population areas of Lusaka where CIDRZ supports government MoH clinics with ARV services, electronic data management, and youth-friendly trained clinical personnel and where GRS has been implementing their basic SKILLZ curriculum and events in secondary schools.

In addition to comparing the effectiveness of the new enhanced SKILLZ-Package we will also evaluate the impact of the SKILLZ-Plus program, a football based curriculum designed specifically for school-aged girls who are living with HIV.

In order to help facilities focus on gaps in the patient experience when accessing health services and adapt health care practices that respond to needs of specific communities, CIDRZ is implementing this study to measure patient experience of HIV treatment delivery in Zambia.

1. Improve patient experience in order to keep patients engaged in care and,

2. Reduce LTFU and mortality through optimising an electronic platform that integrates data from multiple modalities.

The study will also display the information collected in easily understood manner for health care workers to improve patient experience, provide patient-centred coaching and transition to country ownership.