HIV Clinical Trial
Official title:
Evaluating the Role of Peers to Reduce Substance Use Stigma and Improve HIV Care Outcomes in South Africa
Verified date | May 2024 |
Source | University of Maryland, College Park |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Alcohol and other drug use is common among people living with HIV in South Africa and is associated with worse engagement in HIV care. There is evidence that healthcare workers in this setting, including community health workers who play a central role in re-engaging patients back into HIV care, exhibit stigmatizing behaviors towards HIV patients who use substances. In general, healthcare worker stigma towards alcohol and other drug use is associated with poorer treatment of patients who use substances, and in this setting, healthcare worker stigma towards alcohol and other drug use has been associated with worse patient engagement in HIV care. In the United States, peer recovery coaches (PRCs), who are trained individuals with lived substance use recovery experience, have helped patients who use substances engage in healthcare. Theoretically, integrating a PRC onto a healthcare team also increases healthcare worker contact with a person with substance use experience, which may be associated with lower stigma. Yet, a PRC model has not yet been tested in South African HIV care. Therefore, the purpose of this study is to develop and pilot a PRC model integrated into community-based primary care teams providing HIV services in South Africa. The study aims to compare a healthcare team with a PRC to a team without a PRC. The investigators will primarily assess the implementation of this PRC model and rates of patient re-engagement in care.
Status | Active, not recruiting |
Enrollment | 40 |
Est. completion date | August 1, 2024 |
Est. primary completion date | January 29, 2024 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility | 1. HEALTHCARE WORKER: 1. Inclusion Criteria: - At least 18 years old - Employed as a healthcare worker (e.g., community health worker, nurse, supervisor, etc.,) for one of the partner healthcare worker teams that provides HIV re-engagement services 2. Exclusion Criteria: - Unable or unwilling to complete informed consent and study procedures in English, isiXhosa, or Afrikaans 2. PATIENT: 1. Inclusion Criteria: - At least 18 years old - Living with HIV - Problematic alcohol or other drug use defined by either: a) AUDIT-C score = 2; or b) self-report illicit drug use within past 3 months - Seen by a healthcare worker from one of the healthcare teams partnered with this study because of recent disengagement in HIV care 2. Exclusion Criteria: - Unable or unwilling to complete informed consent and study procedures in English, isiXhosa, or Afrikaans |
Country | Name | City | State |
---|---|---|---|
South Africa | South African Medical Research Council - Delft Office | Cape Town | Western Cape |
Lead Sponsor | Collaborator |
---|---|
University of Maryland, College Park | Medical Research Council, South Africa, National Institute on Drug Abuse (NIDA) |
South Africa,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Healthcare Worker Substance Use Stigma | Healthcare worker stigma towards substance use measured using the Social Distance Scale (SDS). SDS scores range from 6 to 24, with higher scores indicating more desired social distance (higher stigma). | 3-months post-baseline assessment | |
Secondary | Patient Re-Engagement in HIV Care | Patient HIV care re-engagement (dichotomous yes/no), assessed via clinic records. | 3-months post-baseline assessment | |
Secondary | Healthcare Worker Feasibility (Intervention Arm Only) | Feasibility subscale of the JHU Applied Mental Health Research (AMHR) D&I Measure, a 15-item measure for assessing dissemination and implementation outcomes in low- and middle-income settings, completed by healthcare worker participants. Items are rated on a 0-3 scale, and averaged, with lower scores (closer to 0) indicating lower feasibility and higher scores (closer to 3) indicating higher feasibility. Findings will be supplemented with qualitative interviews. | 6-months post-baseline assessment | |
Secondary | Healthcare Worker Acceptability (Intervention Arm Only) | Acceptability subscale of the JHU Applied Mental Health Research (AMHR) D&I Measure, a 12-item measure for assessing dissemination and implementation outcomes in low- and middle-income settings, completed by healthcare worker participants. Items are rated on a 0-3 scale, and averaged, with lower scores (closer to 0) indicating lower acceptability and higher scores (closer to 3) indicating higher acceptability. Findings will be supplemented with qualitative interviews. | 6-months post-baseline assessment | |
Secondary | Patient Feasibility (Intervention Arm Only) | Feasibility subscale of the JHU Applied Mental Health Research (AMHR) D&I Measure, a 15-item measure for assessing dissemination and implementation outcomes in low- and middle-income settings, completed by patient participants. Items are rated on a 0-3 scale, and averaged, with lower scores (closer to 0) indicating lower feasibility and higher scores (closer to 3) indicating higher feasibility. Findings will be supplemented with qualitative interviews. | 3-months post-baseline assessment | |
Secondary | Patient Acceptability (Intervention Arm Only) | Acceptability subscale of the JHU Applied Mental Health Research (AMHR) D&I Measure, a 12-item measure for assessing dissemination and implementation outcomes in low- and middle-income settings, completed by patient participants. Items are rated on a 0-3 scale, and averaged, with lower scores (closer to 0) indicating lower acceptability and higher scores (closer to 3) indicating higher acceptability. Findings will be supplemented with qualitative interviews. | 3-months post-baseline assessment |
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