HIV Clinical Trial
Official title:
HIV Prevention for People Living With HIV/AIDS: Evaluation of an Intervention Toolkit for HIV Care and Treatment Settings
The rapid scale-up of HIV care and treatment in resource-limited settings provides the
opportunity to reach many HIV-positive individuals with prevention messages and
interventions in care and treatment settings. However, HIV prevention is rarely incorporated
into the routine care and treatment of people living with HIV, leaving missed opportunities
to reach patients with critical interventions.
This study will evaluate an HIV prevention intervention package for health care settings in
sub-Saharan Africa. The HIV prevention intervention will be delivered to HIV-seropositive
patients in HIV care and treatment clinics during all routine visits. Health care providers
(HCPs) will deliver HIV prevention messages on correct and consistent condom use, disclosure
of serostatus, partner HIV testing, adherence and alcohol reduction. They will also assess
and treat sexually transmitted infections (STIs) and provide basic contraceptives and safer
pregnancy counseling.
Trained lay counselors (LCs) will deliver HIV prevention interventions in the clinics. LCs
will be persons without medical training, many of whom will be PLHIV, who will be trained to
provide HIV prevention counseling, promote HIV testing of partners and children (and provide
HIV testing where allowed by national guidelines), and counsel HIV-positive patients on
medication adherence and alcohol use.
The prevention intervention package will be evaluated in HIV clinics in three sub-Saharan
African countries: Kenya, Namibia, and Tanzania. This project will be a longitudinal
group-randomized trial with 9 intervention clinics (3 per country) and 9 comparison clinics
(3 per country). Two hundred patients per clinic (total N = 3600) will be followed for 12
months. This evaluation will examine the effectiveness of the HIV prevention interventions
delivered by HCPs and LCs on patient-level outcomes such as risky sexual behavior,
disclosure of HIV status, partner HIV testing, alcohol use, HIV antiretroviral (ARV)
medication adherence, STI treatment, pregnancies, and contraceptive use.
In addition to the patient outcomes, the acceptability of the interventions and materials,
as well as the feasibility of integrating the interventions into HIV care and treatment
settings, will be assessed.
Data will be collected via patient interviews, HCP and LC questionnaires, observations of
HCP and LC patient visits, patient medical chart review, and review of clinic service data.
Status | Completed |
Enrollment | 3548 |
Est. completion date | January 2013 |
Est. primary completion date | December 2011 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - At least 18 years old - HIV-positive patients receiving care at a project clinic and seen at the clinic at least twice prior to enrollment - Sexually active within the past three months - Planning to attend the clinic for at least 1 year - Able to conduct interview in one of the following languages: Kenya: English, Kiswahili Namibia: English, Oshiwambo, Damara-nama, Otjiherero, Afrikaans Tanzania: English, Kiswahili - Able to provide informed consent to participate in the project Exclusion Criteria: - Younger than 18 years of age - Not sexually active within the last three months - Planning to move from the vicinity of the clinic within one year - Not enrolled in the HIV clinic and/or have not been seen for at least two clinic visits - Cannot provide informed consent - Patients who are acutely ill or are determined by clinical staff to be too ill to participate - Spouses or identified partners of participating patients - Pregnant women and male partners of pregnant women, as family planning counseling and unintended pregnancy are some of the primary study outcomes - Not able to complete interview in one of the languages in the inclusion criteria - Participated in pilot study |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
Country | Name | City | State |
---|---|---|---|
n/a |
Lead Sponsor | Collaborator |
---|---|
Centers for Disease Control and Prevention | Columbia University, Kenya Ministry of Health, Ministry of Health and Social Welfare, Zanzibar, Ministry of Health, Tanzania, Namibia Ministry of Health and Social Services |
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Unprotected vaginal and anal sex | Baseline | No | |
Primary | Unprotected vaginal and anal sex | 6 month follow-up | No | |
Primary | Unprotected vaginal and anal sex | 12-month follow-up | No | |
Secondary | Number of sex partners | Baseline | No | |
Secondary | Number of sex partners | 6 month follow-up | No | |
Secondary | Number of sex partners | 12 month follow-up | No | |
Secondary | Number of sex partners getting an HIV test | Baseline | No | |
Secondary | Number of sex partners getting an HIV test | 6 month follow-up | No | |
Secondary | Number of sex partners getting an HIV test | 12 month follow-up | No | |
Secondary | Disclosure of HIV status to sex partners | Baseline | No | |
Secondary | Disclosure of HIV status to sex partners | 6 month follow-up | No | |
Secondary | Disclosure of HIV status to sex partners | 12-month follow-up | No | |
Secondary | Alcohol use | Baseline | No | |
Secondary | Alcohol use | 6 month follow-up | No | |
Secondary | Alcohol use | 12-month follow-up | No | |
Secondary | Adherence to HIV antiretroviral medications | Baseline | No | |
Secondary | Adherence to HIV antiretroviral medications | 6 month follow-up | No | |
Secondary | Adherence to HIV antiretroviral medications | 12-month follow-up | No | |
Secondary | Unintended pregnancy or partner pregnancy | Baseline | No | |
Secondary | Unintended pregnancy or partner pregnancy | 6 month follow-up | No | |
Secondary | Unintended pregnancy or partner pregnancy | 12-month follow-up | No | |
Secondary | Provision of family planning counseling and services | Baseline | No | |
Secondary | Provision of family planning counseling and services | 6 month follow-up | No | |
Secondary | Provision of family planning counseling and services | 12-month follow-up | No |
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