HIV/AIDS Clinical Trial
Official title:
Contribution of "Praise Messages" to HIV Treatment Retention and Adherence Among Female Sex Workers in Ethiopia
This study evaluates the effects of praise message phone calls on antiretroviral therapy (ART) initiation, adherence, and prescription refills. The investigators will use randomization to assign newly (diagnosed) HIV positive, ART naive, female sex workers (FSWs) in Ethiopia to a praise message phone call study arm or to a standard of care control study arm.
This study evaluates the effects of praise message phone calls on antiretroviral therapy
(ART) initiation, adherence, and prescription refills. The investigators will use
randomization to assign newly (diagnosed) HIV positive, ART naive, female sex workers (FSWs)
in Ethiopia to a praise message phone call study arm or to a standard of care control study
arm.
Inadequate adherence to ART medication, missed clinics visits and loss-to-follow-up, and
failure to refill prescriptions are major barriers to achieving viral suppression.
Non-adherence is associated with a range of individual, social, community, and structural
factors, including low health literacy, a lack of social support, low socioeconomic status,
substance abuse, stigma and discrimination, and a lack of access to a reliable source of ART
drugs. ART patients' perceptions about a lack of health provider respect and mutual trust are
a possible further barrier to adherence.
Provision of HIV therapy within the MULU/MARPs drop-in-centers has attempted to mitigate some
of the structural and social barriers to ART initiation and retention in care by bringing FSW
friendly treatment services closer to clients and providing intensive counseling services,
social and economic support services, and referrals to additional health services. Improving
client perceptions of health care provider attitudes may further improve retention in care
and adherence to treatment among FSW in Ethiopia. This study will measure the effects of
praise message phone calls delivered the day after, and two weeks after, completing a ART
appointment (i.e. initiation and/or prescription refill) on subsequent ART refills/HIV clinic
visits.
This study will be conducted within PSI/Ethiopia's USAID-funded MULU/MARPs program, which
provides HIV testing, treatment, and other services to female sex workers (FSW) through a
network of drop-in-centers (DICs) across Ethiopia. Consenting FSWs who are living with HIV,
who are ART naive, and who are referred for ART initiation to one of the 25 drop-in-centers
(DICs) selected for "Test and Start" implementation will be enrolled in the study. Pre-study
analysis indicates that each DIC enrolls between 3-4 FSWs living with HIV on ART each month
(mean: 3.6). Over the course of our 9 month study, the investigators expect to enroll a total
of 810 study participants.
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