AzTrials
AzTrials

HIV InfectionsNCT06503666

Zambian Informed Motivated Aware Responsible Adolescent Girls and Adults

A study testing ZAIMARA and Health Promotion in people with HIV Infections and Sexually Transmitted Diseases, run by Centre for Infectious Disease Research in Zambia at 1 site in Zambia.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
Search all trials

Trial summary

The proposed hybrid effectiveness-implementation study will systematically adapt the Informed, Motivated, Aware, Responsible Adolescent Girls and Adults (IMARA) curriculum that was previously adapted for South Africa (IMARA-SA) to use in Zambia (will be renamed Zambian Informed, Motivated, Aware, Responsible… Read more about this study

Who is it for?
Ages 15 to 70 years, women onlyHealthy volunteers can take part
Conditions the study is for
HIV Infections, Sexually Transmitted Diseases
What is being tested?
ZAIMARA and Health Promotion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,200 participants
Where
1 siteZambia
Study dates
7 Apr 2025to 1 May 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 15 to 70 years
  • Women only
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • Adolescent girls and young women (AGYW)
  • 15-19 years-old females (sex assigned at birth)
  • Unmarried
  • Residing outside the five study catchment areas
  • Speak Nyanja, Bemba, or English or a combination (the primary regional languages)
  • Willing and able to provide consent (> 18 years old) and/or assent (< 18 years old)
Show all 21Show fewer
  • Not known to be living with HIV (i.e., no positive test and not on ART)
  • Mother Figures (MF)
  • selected to participate by the AGYW
  • if not the guardian/mother, agreed upon by the guardian/mother
  • > 24 years-old
  • living with or in daily contact with the AGYW
  • speak Nyanja, Bemba, or English or a combination
  • Willing and able to provide consent
  • Peer leaders (ZAIMARA \& Health Promotion)
  • live in the community where they will be working
  • have prior experience working with young people
  • have a minimum grade 12 education
  • be proficient in reading and writing English and/or Nyanja or Bemba
  • are 22-29 years old for AGYW sessions
  • are >30 years-old for MF sessions

Who cannot join

  • AGYW
  • AGYW who are enrolled in other SRH interventions at the time of recruitment (to prevent confounding) or are known to be living with HIV (the needs of AGYW living with HIV are unique and not well-addressed in IMARA-SA, e.g., learning to disclose) will be excluded. Importantly, AGYW who test positive for HIV at the study's baseline assessment will be able to complete the workshops and referred for treatment to avoid stigma.

Trial locations and contacts

1 site in 1 country.

Zambia1 site
  • Chainda, Matero, Chelston, Chongwe and Kalingalinga

    Lusaka, Lusaka Province, 10101

Other trials in Zambia

About this study

The proposed hybrid effectiveness-implementation study will systematically adapt the Informed, Motivated, Aware, Responsible Adolescent Girls and Adults (IMARA) curriculum that was previously adapted for South Africa (IMARA-SA) to use in Zambia (will be renamed Zambian Informed, Motivated, Aware, Responsible Adolescent Girls and Adults (ZAIMARA) and evaluate the impact of ZAIMARA on improving adolescent girls and young women HIV testing, HIV and STI incidence, PrEP uptake and sexual risk behaviour. The study will also assess the impact of monthly mental health screening with referral versus a monthly nutrition and exercise screening on peer leaders job retention. We will also examine implementation factors and outcomes associated with ZAIMARA across five sites.

Read the detailed description

The overall purpose of this study is to adapt the IMARA-SA curriculum for use in the Zambian context and test its impact on AGYW sexual behavior, as well as HIV and STI testing uptake and incidence, and PrEP uptake and persistence.

The study will be conducted in two phases. In Phase 1, we will systematically adapt IMARA-SA and the Health Promotion curriculum for use in the Zambian context using a combination of focus groups, CAB meetings, theater testing, and a formal pilot test. The IMARA curriculum focuses on strengthening communication between adolescent girls and young women (AGYW) and their mother figures (MF) to make healthy sexual decisions, to learn more about HIV, sexually transmitted infections (STIs), and pre-exposure prophylaxis (PrEP) while the health promotion (HP) curriculum promotes healthy living by encouraging good nutrition, knowledge on violence exercise, informed consumer behavior and substance use. The HP curriculum does not explicitly address HIV/STI prevention. Once adapted, the IMARA-SA will be renamed Zambian Informed, Motivated, Aware, Responsible Adolescent Girls and Adults (ZAIMARA).

In Phase 2 we will evaluate ZAIMARA's effectiveness on AGYW HIV testing, HIV and STI incidence, PrEP uptake, and sexual behavior. We will recruit 600 AGYW and MF dyads from the community with assistance from neighborhood health committee members (NHC). If participants agree to enroll in the study, consent/ assent will be obtained from AGYW and MF and they will be invited to participate in a 2-day workshop. On the first day of the workshop, the research assistants and study nurse will conduct clinical tests (HIV \& STI), offer PrEP, collect baseline survey data, and randomize AGYW-MF to receive ZAIMARA or health promotion (HP). The peer leaders will administer the ZAIMARA and HP curriculum in the two days. Once the workshops are completed AGYW and MF dyads will graduate from the program and the study team will conduct follow-up assessments at 6, 12, 18, and 24 months. At the follow-up assessments, AGYW-MF will complete a survey, conduct clinical tests (HIV \& STI), and receive PrEP (for eligible participants).

In addition to the trial component, will enroll the peer leaders who provide the intervention (ZAIMARA/HP) in the study. We aim to examine the impact of monthly mental health screening with referral versus a monthly nutrition and exercise screening on peer leader job retention. We will also evaluate ZAIMARA's feasibility, acceptability, appropriateness, fidelity, cost, and sustainability.

The study will occur in five geographically distinct catchment areas in Lusaka that feed into MoH district clinics/hospitals. The five Clinical Research Performance Sites (CRPS) are Kalingalinga Clinic, Chainda South Clinic, Chongwe Urban Clinic, Chelstone Clinic, and Matero first level hospital (subject to change if required). These clinics were selected based on the high volume of adolescents seeking services at these sites and the surrounding community population of AGYW that will allow us to enroll at least 2-3 AGYW-MF dyads per day in the respective sites.

Being tested
ZAIMARA, Health Promotion
Keywords
Implementation Science, Adolescent Girls and Young Adults, Low and Middle-Income Country
Medical subject headings
HIV Infections, Sexually Transmitted Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ZAIMARABehavioural

    The ZAIMARA curriculum focuses on strengthening communication between adolescent girls and young women (AGYW) and their mother figures (MF) to make healthy sexual decisions, to learn more about HIV, sexually transmitted infections (STIs), and pre-exposure prophylaxis (PrEP). The topics in the curriculum focus on effective communication, mothers talking to daughters on sex, HIV, STIs and PrEP. The intervention consists of participants attending a two day workshops with their MF.

    Other names:

    ZAIMARA

  • Health PromotionBehavioural

    The health promotion (HP) curriculum focuses on healthy living by encouraging good nutrition, improving knowledge on violence recognition, management and support/resources, exercise, informed consumer behavior, alcohol and substance use.The intervention consists of participants attending a two day workshops with their MF.

    Other names:

    HP

Study groups in NCT06503666
Study groupRoleWhat they receive
Zambian Informed Motivated Aware Responsible Adolescent Girls and Young Adults(ZAIMARA)ExperimentalIntervention Arm
Receives: Behavioral: ZAIMARA
Health Promotion (HP)ExperimentalControl Arm
Receives: Behavioral: Health Promotion

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. AGYW HIV testing uptake

    Proportion of AGYW testing for HIV at 6 months

    Measured: Within 6 months following delivery of ZAIMARA & HP curriculum

Secondary outcomes (2)
  1. Incident HIV infection and STIs, PrEP uptake, and AGYW sexual risk behavior

    Proportion of AGYW testing positive for HIV \& STIs , Proportion requesting for PrEP and Proportion of AGYW engaging in sexual risk behaviour

    Measured: Within 6, 12, 18 and 24 months following delivery of ZAIMARA & HP curriculum

  2. AGYW HIV testing at 12, 18, and 24-months

    Proportion of AGYW testing for HIV

    Measured: Within 12, 18 and 24 months following delivery of ZAIMARA & HP curriculum

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Jul 2024
  2. Study start7 Apr 2025
  3. Primary completion1 Dec 2026 (estimated)
  4. Study completion1 May 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
AGYW-MF will be randomized to either ZAIMARA or Health Promotion.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
1,200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06503666
Sponsor's protocol ID
ZAIMARA
Status last verified
Jun 2026
First submitted
10 Jul 2024
Last updated
22 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: All necessary steps will be taken to ensure adherence to all NIH guidelines on sharing raw data.

Publications

  • Donenberg GR, Wilson HW, Emerson E, Bryant FB. Holding the line with a watchful eye: the impact of perceived parental permissiveness and parental monitoring on risky sexual behavior among adolescents in psychiatric care. AIDS Educ Prev. 2002 Apr;14(2):138-57. doi: 10.1521/aeap.14.2.138.23899.

    PubMed 12000232
  • Donenberg GR, Emerson E, Bryant FB, Wilson H, Weber-Shifrin E. Understanding AIDS-risk behavior among adolescents in psychiatric care: links to psychopathology and peer relationships. J Am Acad Child Adolesc Psychiatry. 2001 Jun;40(6):642-53. doi: 10.1097/00004583-200106000-00008.

    PubMed 11392341
  • Donenberg G. Donenberg GR, Brown LK, Hadley W, Kapungu C, Lescano C. Family-based HIV-prevention program for adolescents with psychiatric disorders. In: Pequegnat W, Bell C, editors. Families and HIV/AIDS: Culture and contextual issues in prevention and treatment. New York: Springer; 2012.

  • Donenberg G, Emerson E, Mackesy-Amiti ME, Fletcher F. Sexual risk among African American girls seeking psychiatric care: A social-personal framework. J Consult Clin Psychol. 2018 Jan;86(1):24-38. doi: 10.1037/ccp0000270.

    PubMed 29300099
  • Donenberg GR, Kendall AD, Emerson E, Fletcher FE, Bray BC, McCabe K. IMARA: A mother-daughter group randomized controlled trial to reduce sexually transmitted infections in Black/African-American adolescents. PLoS One. 2020 Nov 2;15(11):e0239650. doi: 10.1371/journal.pone.0239650. eCollection 2020.

    PubMed 33137103
  • Donenberg GR, Sharma A, Kanguya T, Emerson E, Chhun N, Kasengele CT, Mweemba M, Mwenge M, Bosomprah S, Sissoko GD, Hosek S, Moore CB. A hybrid effectiveness implementation trial testing an HIV and STI prevention program for mother figures and their adolescent girls and young women delivered by peer leaders: ZAIMARA study protocol. BMC Public Health. 2025 Sep 30;25(1):3153. doi: 10.1186/s12889-025-24332-5.

    PubMed 41029332

Questions about this trial

What is this clinical trial studying?

A study testing ZAIMARA and Health Promotion in people with HIV Infections and Sexually Transmitted Diseases, run by Centre for Infectious Disease Research in Zambia at 1 site in Zambia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 21 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 22 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Zambia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

AGYW HIV testing uptake (time frame: Within 6 months following delivery of ZAIMARA & HP curriculum). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06503666, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jun 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in