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Evaluating an HIV Risk Screening Tool for Orphans and Vulnerable Children in Tanzania

Completed
Conditions
Pediatric HIV Infection
Registration Number
NCT04517760
Lead Sponsor
Elizabeth Glaser Pediatric AIDS Foundation
Brief Summary

The goal of the research was to evaluate the performance of items within the Kizazi Kipya (K2) Orphan and Vulnerable Children (OVC) HIV risk screening tool in identifying HIV-positive children, to optimize an HIV screening tool for OVC and children and adolescents in facility settings and to assess the feasibility and acceptability of home-based HIV risk screening and testing.

Detailed Description

Under the ongoing community-based Kizazi Kipya (K2) OVC project, program staff currently administer a 13-item HIV risk screening tool to all K2 program beneficiaries, and refers those who screen positive to facility-based HIV testing. A subset of this 13-item tool is a module of four items that had previously been used as a standalone four-question screening tool in facilities in Zimbabwe.

The primary objectives of this study are as follows.

1. To evaluate the performance of a lay cadre-administered four-item subset of the K2 HIV risk screening tool that matches the Zimbabwe evidence-based tool in predicting the HIV status of vulnerable children/adolescents represented by two populations: (a) K2 OVC beneficiaries and (b) children/adolescents attending health facilities.

2. To identify additional items in the K2 HIV risk screening tool that could be added to the four-question subset to improve the tool's performance.

3. To assess fidelity to the administration of the OVC HIV screening tool items through structured observations of community case workers in the K2 program.

4. To assess the acceptability of OVC HIV risk screening and testing implemented in the community among OVC beneficiaries in the K2 program.

5. To assess the acceptability and feasibility of integrating the OVC HIV screening tool with HIV testing among OVC community case workers in the K2 program.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
21080
Inclusion Criteria
  • Living in a household deemed to be at elevated HIV risk based on previously identified risk criteria
  • Attending a study health facility in two regions of Tanzania
  • Age 2-19 years
Exclusion Criteria
  • Previously tested HIV-positive
  • History of antiretroviral treatment (ART)
  • Unable or unwilling to be consented
  • Age 5-19 years old, tested negative in past 6 months, and having no reported exposure to HIV through sexual contact (consensual, abuse) or through blood transfusion/needle injury.

Community care workers:

Inclusion criteria:

  • conducting HIV risk screening in OVC households as part of their role in the Kizazi Kipya project in the subset of study districts where structured observations and focus group discussions were conducted

Exclusion criteria:

  • unwilling to consent to the study

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Specificity of HIV risk screening toolWithin four weeks

Children/adolescents testing HIV negative on the tool who are truly HIV negative

Sensitivity of HIV risk screening toolWithin four weeks

Children/adolescents testing HIV positive on the tool who are truly HIV positive

Positive predictive valueWithin four weeks

Proportion of children/adolescents testing positive on the tool who actually have HIV

Negative predictive valueWithin four weeks

Proportion of children/adolescents testing negative on the tool who do not actually have HIV

Acceptability of HIV risk screening toolWithin six weeks

Examining the extent of reception of the screening tool by the OVC caregivers and the community case workers using a semi-structured questionnaire

Feasibility of HIV risk screening toolWithin six weeks

Exploring the practicality of use of HIV risk screening tool through focus group discussions with community case workers

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Elizabeth Glaser Pediatric AIDS Foundation

🇹🇿

Dar es Salaam, Tanzania

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