HIV Clinical Trial
Official title:
Peer Delivery of HIV Self-Screening to Support Linkage to HIV Prevention in Rural KwaZulu-Natal, South Africa: A Cluster Randomized Control Trial
Hypothesis: HIV-Self-Test (HIV-ST) will allow peers or peer-networks to effectively and
efficiently link older adolescent girls and young women into HIV prevention and care
services.
Design: A cluster randomized control trial comparing two models of peer delivery of HIV-ST,
through incentivized respondent driven peer networks and direct distribution by peer
navigators compared to standard of care (referral to HIV testing, prevention and care
services by peer navigators) in improving the uptake of HIV prevention and care amongst young
women (18-24) living in the rural uMkhanyakude district of KwaZulu-Natal, South Africa.
Objectives:
1. To increase the knowledge of HIV status among young women aged 18-24 years old through
distribution of HIV-ST through incentivized peer networks or direct distribution by peer
navigators compared to peer navigators referring into HIV testing services.
2. To determine an increase in the rate of linkage among young women aged 18-24 to HIV
prevention and treatment services facilitated by distribution of HIV-ST through
incentivized peer networks or direct distribution by peer navigators compared to peer
navigators referring into services.
3. To conduct a process evaluation of the acceptability, feasibility, and reach (out of
school, recently migrant and living in remote areas) in linking 18-24-year-old women to
HIV prevention and treatment services of HIV-ST distribution through incentivized peer
networks, or direct distribution by peer navigators or peer navigators referring into
services.
4. To measure the cost per 18-24-year-old linked to prevention and care through peer-led
incentivized HIV-ST delivery system or direct distribution of HIV-SS by peer navigators,
compared to peer navigator referring into services.
Primary Outcomes:
The difference between the rate of linkage within three months of 18-24 years old women to
HIV confirmatory testing and pre-exposure prophylaxis (PrEP) eligibility screening if
HIV-negative and antiretroviral treatment (ART) starting if HIV-positive. It will be between
the two peer-delivery approaches to HIV-ST distribution (incentivized HIV-ST delivery through
peer network and direct distribution of HIV-ST by peer navigators) compared to standard of
care (peer navigator referral to HIV testing, treatment and prevention services). Rate is
defined as the number of linkages per month of peer navigator outreach activity.
Status | Not yet recruiting |
Enrollment | 2000 |
Est. completion date | December 31, 2019 |
Est. primary completion date | October 31, 2019 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Female |
Age group | 18 Years to 24 Years |
Eligibility |
Inclusion Criteria: - Females - Aged 18-24 years - Not currently on ART - Provide written informed consent Exclusion Criteria: - Under 18 years or older than 24 years - Participants not willing to consent or unable to provide informed consent - Males - Currently on ART |
Country | Name | City | State |
---|---|---|---|
n/a |
Lead Sponsor | Collaborator |
---|---|
University College, London | Africa Health Research Institute, London School of Hygiene and Tropical Medicine |
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | The rate of linkage among women ages 18-24 years to HIV prevention services. | The rate of linkage per month of peer navigator activity to a confirmatory testing and pre-exposure prophylaxis (PrEP) eligibility screening if HIV-negative and antiretroviral treatment (ART) starting if HIV-positive. | within 3 months of receiving the intervention | |
Secondary | The number of linkages per 100 clinic referral slips distributed per arm; | The number of linkages to a confirmatory testing and pre-exposure prophylaxis (PrEP) eligibility screening if HIV-negative and antiretroviral treatment (ART) starting if HIV-positive per 100 clinic referral slips distributed per arm. | within 3 months of receiving the intervention. | |
Secondary | The change in proportion of all residents (men and women) aged 18-24 years who are aware of HIV-SS and who have used HIV-SS over time | Using routine annually collected data from the surveillance area | 12 months following intervention end date | |
Secondary | Comparison of the difference per study area in the proportion of 18-24 year olds who report knowledge of HIV status and uptake of ART, PrEP and voluntary medical male circumcision (VMMC) | Using routine annually collected data from the surveillance area | 12 months following intervention end date | |
Secondary | Comparison of the pattern of recruitment per arm of study | The proportion of hard to reach adolescent girls and young women (aged 18-24 years) - defined as out of school, recently migrated and those who live in remote areas - linked to care in the three arms of study | 12 months following intervention end date | |
Secondary | Comparison of costs per case linked to PrEP eligibility assessment (HIV-) and cost per case started on ART (HIV+) in intervention and control arms | To establish costs, we will use both a bottom-up ingredient-based costing approach and a top-down costing approach using the study budgets and expenditure reports. | 6 months study implementation period |
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