HIV Clinical Trial
Official title:
Assessing Strategies for Increasing Male Involvement in Malawi's Antenatal Program
In sub-Saharan Africa, engaging men in HIV prevention, care, and treatment has proven
challenging. Along all steps of the HIV care-seeking cascade, men exhibit worse care-seeking
behaviors than women. They are less likely to be tested for HIV, initiate combination
antiretroviral therapy (cART), and be retained in cART care. Additionally, men rarely engage
in the care of their female sex partners, even though couple care-seeking is associated with
marked improvements in condom use within HIV-discordant couples. Option B+, Malawi's program
for providing immediate, lifelong combination antiretroviral therapy (cART) to all
HIV-infected pregnant women at the time of diagnosis, is an important entry-point for
involving male partners in care.
This is a pilot randomized controlled trial (N=200 women) comparing two strategies of male
partner involvement within the Option B+ program. In both arms (patient referral and
contract referral) women will be encouraged to invite their male partners to accompany them
to the clinic for couple HIV counseling and testing. In the contract referral arm, if the
couple does not present within one week, the male partner will receive a home visit
encouraging them to present to the clinic. We will compare the two arms for 1) uptake of
couple HIV counseling and testing (cHCT), 2) uptake of cART for women, and 3) linkage to
care for HIV-infected men. Results are expected to inform a larger trial and ultimately
improve care-seeking in Malawi's HIV program.
Objective 1: Determine acceptability of male partner recruitment for cHTC within an Option
B+ context. We will assess acceptability of eligible females to participate in this pilot
RCT and reasons for non-participation.
Objective 2: Assess whether study arm (patient referral versus contract referral) is
associated with cHTC uptake. We will conduct a pilot randomized controlled trial (RCT) of
male partner recruitment. This study will contain two arms: patient referral and contract
referral for uptake of cHTC (primary outcome).
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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