HIV Care Cascade and Linkage to Antiretroviral Therapy Among Hospitalized Adults in Lusaka, Zambia

Completed

• Conditions: Hiv
• Interventions: Other: Standard of care

• Registration Number: NCT03158844
• Lead Sponsor: University of Alabama at Birmingham

Brief Summary

The population of inpatients is large in Zambia; however, because of poor linkages between hospitals and community HIV care, there are few data to analyze their engagement in HIV care before and after hospitalization. The goal of the study is to learn more about Zambian adults who are HIV-infected and get hospitalized. The purpose of this study is to gather formative, preliminary data, to be used in future grant applications to improve linkage and engagement in HIV care in Zambia.

Detailed Description

The main objective of this study is to generate preliminary data on the outcomes of Zambian HIV-infected individuals after discharge from University Teaching Hospital (UTH) Internal Medicine wards which can inform development of a linkage intervention. Our central hypothesis is that in Sub-Saharan African settings like Zambia hospitalizations among HIV-infected individuals are driven by suboptimal linkage and initiation of ART following HIV diagnosis. Specific Aims: (a) Characterize the distribution of hospitalized 300 HIV-infected adults across the HIV care continuum. (b) Identify structural, psychosocial, clinic, and medical factors that predict suboptimal linkage to care and ART initiation after 90 days of hospital discharge among HIV-infected Zambians.

Study Timeline

• Study First Submitted: 2017-05-08
• Study Start: 2017-05-16
• Study First Submitted QC: 2017-05-16
• Study First Posted: 2017-05-18
• Primary Completion: 2018-02-28
• Study Completion: 2018-05-31
• Status Verified: 2018-08
• Last Update Submitted: 2018-08-08
• Last Update Posted: 2018-08-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 250

Inclusion Criteria

• 18 years or older
• HIV-infected as documented in the UTH file
• Admitted to Internal Medicine Ward at UTH

Read More

Exclusion Criteria

• Unable to provide informed consent
• Not planning to remain in Lusaka province for 3 months after discharge

Read More

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
HIV+ patients (Standard of care)	Standard of care	300 HIV-infected and hospitalized adult patients at the University Teaching Hospital (UTH) will be recruited.
Health systems informants	Standard of care	15 key Zambian health systems informants and leaders who can discuss inpatient care and the process of linking hospitalized patients to HIV care.

Primary Outcome Measures

Name	Time	Method
Undetectable HIV viral load at 90 days post-discharge	90 days after hospital discharge	Numerator is number with HIV RNA \<1000 c/mL tested at 90 days after hospital discharge; denominator is the # enrolled

Secondary Outcome Measures

Name	Time	Method
Proportion of HIV-infected inpatients who are on ART upon admission	Baseline	Numerator is number who report taking ART up to the time of admission; denominator is the # enrolled
Mortality rate	90 days after hospital discharge	Mortality from time of enrollment to 90 days after discharge
ART initiation	Baseline and 90 days after hospital discharge	Proportion not on ART upon admission to hospital who are on ART at 90 days after hospital discharge

Trial Locations

Locations (1)

University Teaching Hospital; 🇿🇲 Lusaka, Zambia