HIV Clinical Trial
Official title:
Activating Treatment as Prevention Through Community Mobilization in South Africa
The purpose of this study is to evaluate the impact of a community mobilization intervention on the uptake of HIV testing, linkage to and retention in HIV care using a community, cluster randomized trial.
Eight of 16 intervention naïve communities in the Agincourt HDSS will be randomized to
receive the CM intervention to activate TasP based on the investigators CM conceptual
framework. The 16 villages will be randomized based on the "restricted randomization"
approach, a stratification method to ensure overall balance between intervention and control
communities.
Intervention activities will map onto the investigators six mobilization domains identified
in the investigators preliminary work as key components for communities to mobilize for
change around HIV prevention. These activities will support communities to: 1) identify a
shared concern around testing, linkage and retention in care; 2) enable communities to
develop critical consciousness around TasP; 3) facilitate identification and development of
structures and networks to disseminate information and activities around TasP; 4) identify
and engage community leadership around TasP; 5) take collection action to support TasP; and
6) build community cohesion to address the HIV epidemic and support access to care.
The investigators will evaluate the impact of the intervention using a linked data set
including electronic clinic records and the HDSS census data, which will allow us to
determine whether people in the intervention communities test at higher proportions than
those in control communities, whether individuals who test positive in the intervention
communities are more likely to receive CD4 testing and initiate treatment within 3 months
than the control communities, and whether those who are eligible and not eligible for
treatment are retained in care.
The investigators will implement a representative cross-sectional survey in all 16 villages
prior to and following the intervention in order to examine changes in CM domains across
villages and the mechanisms through which the intervention affects HIV testing, linkage and
retention.
In addition, intervention progress and dosage will be carefully monitored through a tracking
system to document all workshops and activities that are carried out in each village.
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