The Coach Mpilo Study: evaluation of a peer-led intervention to promote engagement in HIV care for men living with HIV in South Africa

Created by Population Services International (PSI) and Matchboxology, Coach Mpilo employs ‘coaches’ (a term found to resonate in formative research with men and the concept of ‘getting back in the game’) to work 1-on-1 with men living with HIV (‘players’) and tailor support for each man to help him re-engage and stay in care. Coaches provide support for a period of up to six months, during which they engage with clients about once every week, with greater contact as needed based on the complexity of challenges faced.

2026-04-15

2027-12-31

Retention in HIV care at 12 months

Retention in HIV care at 12 months is defined as attending a follow-up clinic visit on or before 12 months and obtaining adequate ART refills for a supply of medications at 12 months post study enrolment.

Retention in care at 6 months and viral suppression (<50 copies/ml) at 6 and 12 months.

Secondary outcomes include retention in care at 6 months; viral suppression (<50 copies/ml) at 6 and 12 months; and adherence over 6 and 12 months using proportion of days covered (PDC). In addition, we will examine outcomes measured in the 6-month follow-up survey: HIV-status disclosure, mental health, internalized stigma, self-esteem, employment and social isolation.

In partnership with the Department of Health in KwaZulu-Natal Province, HST and Matchboxology, a South African organisation that designs health and social programs, we will conduct a randomised controlled trial (RCT) with men living with HIV who have dropped out of HIV care (i.e., having missed a clinic appointment by >28 days).

Recruitment to the study will occur in parallel to the delivery of the standard of care (SOC) to men disengaged from HIV treatment. To be included in the study men living with HIV must meet the following criteria: (a) aged ≥18 years; (b) previously receiving HIV care at the study clinic; (c) missed their most recent ART clinic appointment by >28 days, (d) not planning to relocate to another region within the next 12 months; (e) able and willing to provide informed consent; (f) not currently taking ART. Importantly, agreement to be contacted by a coach (if selected) is not an eligibility criterion as our goal is to obtain generalizable evidence of the overall effectiveness of the Coach Mpilo program.

Data collection includes baseline and six-month follow-up surveys, extraction of clinical outcomes from electronic health records, and logbooks maintained by peer mentors documenting participant engagement. The primary outcome of interest is retention in HIV care at twelve months, defined as attendance at a follow-up clinic visit and adequate ART refills within the twelve-month period following enrolment. Secondary outcomes include retention at six months, viral suppression, adherence to ART, and psychosocial indicators such as internalised stigma, self-efficacy, and social support.

Not available

Following the baseline survey, participants will be randomized (1:1) to a control group that receives the SOC and an intervention group that receives SOC plus the Coach Mpilo intervention. This randomization is performed by a computer.

Individual

No

~800 men

~800 men

total sample of ~800 men with ~400 men assigned to control and ~400 men assigned to treatment