Peer Group Support to Children and Adolescents with HIV: A Randomized Controlled Trial in Vietnam

Children and adolescents with HIV receiving antiretroviral therapy (ART) often experience poorer treatment outcomes than adults due to inconsistent adherence, leading to poor viral suppression, increased morbidity, and higher mortality. While studies in Sub-Saharan Africa have shown that peer group support can improve adherence among adolescents, its effectiveness in Asian populations remains unclear. This study evaluated the impact of peer group support on reducing virological failure among adolescents with HIV receiving ART. A multicenter pragmatic randomized controlled trial was conducted from July 2020 to January 2022 across four cities in Vietnam: Hanoi, Ho Chi Minh City, Ha Long, and Hai Phong. A total of 630 children and adolescents aged 10-16 years were randomized to either an intervention or control group. Both groups received standard HIV care according to Vietnamese national guidelines, while the intervention group additionally participated in peer support sessions. Virological failure was assessed through viral load measurements at study completion. Primary analyses followed an intention-to-treat approach using multivariable logistic regression adjusted for baseline viral status and study site. After 18 months, virological failure rates were similar between groups, with no statistically significant difference observed (adjusted OR: 1.03; 95% CI: 0.50-3.37; p > 0.05). Findings were consistent in per-protocol analyses. The limited impact may reflect already low virological failure rates and strong adolescent HIV care systems in Vietnam. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT02035969.