Integration of HIV Care and Treatment Into Antenatal Care in Migori District, Kenya
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1,172
- 试验地点
- 1
- 主要终点
- Vertical transmission of HIV
研究概览
简要总结
This study seeks to determine the most effective way to reach and provide pregnant women with accessible, comprehensive, and high quality HIV care and treatment.
详细描述
This study uses a prospective cluster randomized design. Twelve clinics similar in size, population, and services in Migori district, Kenya that provide ANC have been randomly assigned to receive "integrated ANC, PMTCT & HIV services" (intervention arm) or "non-integrated services" (control arm). At the intervention clinics, pregnant women will receive ANC, PMTCT and HIV care and treatment (including HAART if required) at the same clinic visit from the ANC provider. At the control clinics, women will receive antenatal care and PMTCT services with referral to the HIV care and treatment department located in the same facility. The control sites more closely resemble the current approach followed for care and treatment of HIV-infected pregnant women in Kenya. The content of ANC, PMTCT, and HIV care will be the same in the two study arms and will follow current Kenyan national guidelines. The only difference between the two arms will be the provider/location of HIV care and treatment.
Outcomes will be compared for HIV-positive pregnant women who attend intervention versus control facilities. In addition we will conduct qualitative research with health care providers at the study health facilities in order to learn provider perspectives on the two service models and to explore the effects of integration on provider job satisfaction (including work load).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •FOR SITE INCLUSION:
- •Each site must provide ANC services
- •Each site must provide HIV testing services for pregnant women
- •Each site must have an average of at least 20 new ANC clients per month
- •FOR ENROLLMENT OF HIV-POSITIVE WOMEN:
- •All women testing HIV-positive at one of the 12 ANC clinics included in the study will be asked to participate in the study
- •FOR HEALTH PROVIDER INCLUSION IN INTERVIEWS:
- •Health care staff must work within the ANC clinic at selected facilities
- •Staff must be able to read and speak English well enough to complete the informed consent process, participate in a one-on-one in-depth interview in English and complete a brief self-administered questionnaire
排除标准
- •FOR SITE EXCLUSION:
- •If all of inclusion criteria are not met the site will be excluded
- •If site is already providing integrated ANC/HIV care services
- •FOR HEALTH PROVIDER INCLUSION IN INTERVIEWS:
- •If all of inclusion criteria are not met the site will be excluded
结局指标
主要结局
Vertical transmission of HIV
时间窗: 3 months postpartum
次要结局
- Maternal HIV treatment outcomes(6 months, 1 year)
- Provider job satisfaction(1 year)
- Infant HIV testing uptake(3 months postpartum)
- Patient enrollment, retention and adherence in HIV care and treatment(6 months, 1 year)
研究者
Craig Cohen
Professor
University of California, San Francisco