An Adaptive Platform Trial for Evaluation of Novel Treatment Regimens in Children and Adolescents With HIV in Africa

The goal of the CHAPAS-5 clinical trial is to find out how well different HIV treatments work in children and young people (from 4 weeks up to under 15 years old) living with HIV, including those starting treatment for the first time and those whose current treatment is not working well. The study aims to learn whether newer or different combinations of medicines can better control the virus, be safer, and be easier to take. The main questions it aims to answer are: * Can these treatments help children stay alive and keep their HIV virus at very low levels (viral load below 400) after 48 weeks? * Which treatment options are most effective, safest, and easiest for children and their carers to use? Researchers will compare different treatment groups to see if some medicines work better than others. Participants will be given one of several HIV treatment combinations (all already used in care), and these will be compared to see if they lead to: * Better control of HIV * Fewer side effects * Improved quality of life Participants will: * Be randomly assigned (like flipping a coin by computer) to one suitable HIV treatment * Take their HIV medication every day as prescribed * Attend clinic visits over about 1-2 years At these visits, they will: * Have blood tests to check HIV levels and general health * Have health check-ups (e.g. weight, symptoms, side effects) * Answer simple questionnaires about: * How easy the treatment is to take * Mood, sleep, and wellbeing * Quality of life * Receive support to help them take their medication regularly Some participants may also take part in optional extra studies (for example, to understand how the drugs work in the body). Overall, this study aims to identify the best HIV treatments for children and young people, so future care can be more effective, safer, and easier to follow.