Zanoni Lab

The Zanoni Lab is dedicated to improving engagement in care for adolescents with HIV. Dr. Brian Zanoni began his research career after treating children and adolescents in Botswana and South Africa from 2006 – 2012. He started several HIV treatment programs soon after antiretroviral therapy was available for children with HIV in South Africa. The Zanoni lab focuses on improving outcomes for children born with HIV from adolescence to adulthood. Adolescents often fall out of care when they transition to adult clinics. We strive to learn what can be done to keep adolescents engaged in care and improve their management of their own health.

Our strong partnerships with academic medical centers in South Africa allow us to implement our research portfolio internationally with expansive geographical coverage. Our South African research partners include University of KwaZulu-Natal, Africa Health Research Institute, University of Witwatersrand, and University of Western Cape. Our leadership in the Adolescent HIV Implementation Science Alliance-South Africa also serves as a platform to engage local healthcare providers and researchers with our evidence-based interventions for adolescents living with HIV. 

The Zanoni lab also supports young clinician scientists who wish to focus their early careers on pediatric/adolescent HIV or implementation science research. Our team consists of masters of public health students, medical students, fellows, residents, junior faculty, and clinical research personnel who are proficient in both qualitative and quantitative research methods. Please head to our lab members page to learn more about our team.

Dr. Zanoni and his team design interventions to help adolescents living with HIV remain engaged in care and improve self-management. Our interventions leverage technologies and implementation science to optimize engagement in care and uptake of our interventions. One of our interventions involves peer support groups where adolescents with HIV have in-person or virtual chat groups moderated by healthcare providers. Our ongoing study (R01 MH131434) is enrolling 800 adolescents to evaluate the efficacy, implementation, and costs of in-person and virtual peer support interventions to determine the best strategy to retain adolescents in care.

In 2024, Dr. Zanoni and the team are launching a new study (UG1 MD019435) involving 13 hospitals/clinics in South Africa evaluating the efficacy and implementation of peer navigation and the use of long-acting injectable antiretroviral therapy. A previous study has found long-acting injectables can help change patients’ outlook in life, as they wouldn’t have to be reminded of their HIV every day when taking daily pills if they can receive an injection either monthly or every 2 months.

Our team has also launched the “eHARTS” app that evaluates risk factors for adolescents falling out of care and not taking their medicine. The app surveys patients about their knowledge of HIV, how they navigate the health system, asks about their demographic factors, and if they failed treatment regimens before. After taking the survey, the app will let them know whether they are ready for transitioning to adult care. Those who score low and intermediate can be enrolled in an intervention to better prepare them for the transition.

Another important pilot study is looking at how effective virtual healthcare visits are in South Africa. Dr. Zanoni and his team are conducting mock virtual healthcare visits between adolescents and healthcare providers. They are then interviewing clinicians and adolescents to determine the acceptability and feasibility of virtual healthcare visits in South Africa.