HIV Clinical Trial
Official title:
Feasibility of an Interventional Project to Reduce HIV Incidence Among People Who Inject Drugs in Haiphong, Viet Nam
This study aims at assessing the feasibility of implementing an interventional cohort of
people who inject drugs in Haiphong, Viet Nam.
For this purpose, the investigators will conduct a RDS survey to i) assess the current
situation of drug use behaviour, HIV and Hepatitis C Virus (HCV) infection in the study
population and ii) recruit participants for the longitudinal phase. The latter will consist
of enroling the most difficult to reach People Who Inject Drugs (PWID) (those not followed by
health centers), including early injectors, Men who have Sex with Men (MSM) and female sex
workers (FSW) and following them up for 6 months in order to estimate the follow-up rate and
preliminary estimates of HIV and HCV incidence.
Objectives:
The primary objective of the DRIVE-IN project is to evaluate the feasibility of implementing
an interventional cohort of PWID in Haiphong. Such a cohort (DRIVE) will be instrumental in
demonstrating the efficacy of a community-involved intervention integrating prevention and
care in order to reduce HIV and HCV transmission among PWID in Haiphong.
The main expected result of DRIVE-IN is to demonstrate that enrolment and follow-up of
various hard-to-reach subgroups of PWID is feasible in the local context. These feasibility
objectives will be evaluated using a set of relevant indicators.
Design:
The research will first include a respondent-driven sampling (RDS) survey, including a
maximum of 600 PWID. Then 250 RDS participants (i.e about a quarter of the future DRIVE
cohort) will be selected for a longitudinal study, with an enrolment and 3 follow-up visits
at week 4, 12 and 24. In parallel, four qualitative studies will be implemented: one study to
explore how to reach the hardest-to-reach and most-at-risk PWID, one feed-back study on PWID
feeling about their participation in the research, one study investigating the reasons of
drop-outs, and a final study on the research process itself.
Endpoints:
The RDS will describe the target population and the patterns of drug use. The feasibility of
implementing an interventional cohort will be evaluated on several indicators:
- International multi-disciplinary research network is operational
- Completion of recruitment within the time frame
- Follow-up rate >80% at 24 weeks
- Implementation and increased access to peer-led interventions
- Establishment of a data management center
- Improved laboratory capacities for research
- Documented support of local and national authorities
Study population RDS survey Inclusion criteria Age > 18 years Self-reported drug injector
confirmed by a positive urinary test and either skin marks of injection or knowledge of
injecting procedures Signed informed consent Non-inclusion criteria Unable of understanding
informed consent and answering questionnaires
Longitudinal study Inclusion criteria Having participated to the RDS survey Signed informed
consent specific to the longitudinal study Non-inclusion criteria Ongoing Methadone
Maintenance Therapy (MMT) Ongoing antiretroviral therapy Health status not compatible with
study follow-up Have a plan to move out of Haiphong over the next two years. Have been
sentenced recently to a prison term
Follow-up and study visits contents:
Participants of the longitudinal phase will be followed at week 4, 12 and 24 (final visit).
During the RDS, face-to-face questionnaires will be applied on drug use, sexual health, and
referral to care and repeated at each follow-up visit, along with the record of medical
events. In addition, a urinary test will be collected at the RDS to assess the range of
recent drugs used, and repeated at the final follow-up visit (week 24). Finally, at the RDS
and final visit, HIV, HCV, Hepatitis B Virus (HBV) serology will be done along with
appropriate counselling.
Sample size:
- 603 PWID will be enrolled in the RDS survey
- 250 RDS participants will be enroled in the longitudinal phase, including:
- 140 PWID for > 2 years, including females
- 50 recent injectors (< 2 years from first injection)
- 30 FSW who inject drugs
- 30 MSM who inject drugs
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