HIV Clinical Trial
Official title:
Z 31601 - Understanding Longitudinal Clinical Outcomes and Post-release Retention in Care Among HIV-infected Prisoners in Lusaka, Zambia
To inform the design of a future transitional HIV care intervention for releasees, the study proposes to prospectively assess clinical outcomes for HIV-infected prisoners after release; explore factors from health behavior theory that are associated with post-release retention in care, with a special focus on Alcohol Use Disorders (AUDs); and conduct formative research to determine releasee and stakeholder knowledge, attitudes, and preferences surrounding transitional care interventions.
The study will enrol approximately 552 releasees from Lusaka Central Facility, Mwembeshi
Correctional Facility, Kamwala Remand Centre, and Chainama Correctional Facility and Kabwe
Correctional Complex. HIV care retention, mortality and changes in CD4 count and HIV-1 viral
load at 6 month post-release information will be obtained from the SmartCare database.
Validated psychometric instruments will be used to assess AUD prevalence and alcohol use
severity pre-incarceration, at release and about 3 to 6 months post-release. Using
mixed-methods, effects of AUDs on retention in care at 3 and/or 6 months post-release will be
estimated.
Sub-group analyses among HIV-infected individuals on ART and those enrolled in care but not
yet on ART (i.e. pre-ART) will enable assessment of AUD effects on biological markers of HIV
disease control and progression.
The Behavioural Model for Vulnerable Populations, and validated psychometric instruments,
questionnaires, and in-depth interviews, factors beyond AUDs that may influence post-release
retention in HIV care will be evaluated. Finally, preferred and relevant program elements for
a future prisoner transitional HIV care pilot will be examined by conducting in-depth
interviews with a purposive sample of approximately 26 HIV-infected releasees and leaders
from the Zambian government and prominent implementing partner organizations, as well as
focus group discussions with frontline prison officers, health workers, and representatives
of leading civil society organizations in Zambia.
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