ENGAGE PROJECT

NAME OF THE PROJECT;- ENGAGE

TIME;- 4 YEARS (2023-2026)

DONOR;-Karolinska Institutet (KI)

ENGAGE is a four-years (2023-2026) research project implemented jointly by MDH and Karolinska Institutet (KI) of Stockholm, Sweden. The project is built on the foundation of MDH and KI’s previous research work evaluating progress and outcomes of the program for prevention of vertical HIV transmission from mothers to their babies during pregnancy, childbirth and breastfeeding (also known as PMTCT) in Dar es Salaam, Tanzania (1–4). This work revealed that pregnant and breastfeeding adolescent girls and young women (AGYW) aged 15-24 years living with HIV are lagging, having poorer adherence and retention on HIV treatment and elevated risks of HIV transmission to their babies, as compared to older women. The ENGAGE project was further motivated by the double burden of high rates of teenage pregnancy and new HIV infections among AGYW in Sub-Saharan Africa (SSA), including Tanzania (5–9).

The ENGAGE project, therefore, aims to investigate and optimize healthcare for pregnant and breastfeeding AGYW living with HIV to prevent HIV transmission to their babies, and improve their HIV treatment and reproductive health outcomes. The project is implemented across three regions of Dar es Salaam, Kagera and Tabora in Tanzania, in collaboration with the Ministry of Health (MOH), the President’s Office Regional Authorities and Local Government (PORALG) and the Regional and Council Health Management Teams (RHMTs).

The ENGAGE project has seven specific aims organized into four phases. Phase I has three aims focusing on quantifying and characterizing the problem using data from a large registry-based cohort of women enrolled in PMTCT services in routine healthcare. Phase II comprises of two aims focusing on understanding context and drivers using qualitative consultations with the AGYW, their healthcare providers, partners, parents/guardians and community stakeholders, and the other on a systematic review of evidence on potential solutions. Phase III has one aim which entails engaging the AGYW and other key stakeholders to utilize findings from phase I and II to co-design and prototype a tailored package of micro-interventions to optimize healthcare for pregnant and breastfeeding AGYW living with HIV. Phase IV also has one specific aim to pilot test the developed micro-interventions package for feasibility and preliminary effect. The seven specific aims of the ENGAGE project are further described
below:

The ENGAGE project contributes to the growing body of evidence on optimizing HIV treatment, vertical HIV prevention and reproductive healthcare for young girls and women who are pregnant or postpartum and living with HIV. Such evidence is highly needed to ensure that no one is left behind in the efforts to end AIDS as a public health threat, and empower all