Family-centered HIV Care, Viral Suppression and Retention in HIV-positive Children, Swaziland
- Conditions
- HIV Infections
- Interventions
- Other: FAM-CARE
- Registration Number
- NCT03397420
- Lead Sponsor
- Elizabeth Glaser Pediatric AIDS Foundation
- Brief Summary
The study will evaluate the effect of implementing a family-centered care (FAM-CARE) program (where all HIV-positive family members are seen together as a unit and receive care together) on viral suppression and retention in HIV-positive children \<15 years through enrollment of a prospective cohort of 660 HIV-positive children and their caregivers at sites that were randomized to either implement the family-care program (intervention sites) or continue the current standard of care (control sites).
- Detailed Description
The proposed study will evaluate the effect of implementing a FAM-CARE program on viral suppression and retention in children through enrollment of a prospective cohort of HIV-positive children and their caregivers at sites implementing the FAM-CARE program and control sites continuing the current standard of care. The study will be conducted in four "clusters" of facilities (2 hospitals and 2 health centers and their filter clinics) in the Hhohho region of Swaziland. Two facility "clusters" (one hospital and one health center, with their filter clinics) will be randomized to initiate the FAM-CARE program with viral load monitoring and two "clusters" (one hospital and one health center, with their filter clinics) will be control standard-of care sites. A prospective cohort of HIV-positive children and their caregivers will be followed in the FAM-CARE program sites and control sites. Each child will be followed for 18 months following enrollment. The primary objective is to evaluate the effect of the FAM-CARE program on the rates of viral suppression and retention in care, comparing rates of viral suppression and retention in children enrolled in FAM-CARE versus control sites. The study will also evaluate factors associated with viral suppression and retention (including family demographic characteristics), and conduct qualitative interviews to assess the acceptability of the FAM-CARE program by caregivers and health care providers in the intervention sites.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 742
- HIV-positive child aged <15 years receiving HIV care at the study facility.
- At least one family member residing in the household is also HIV-positive and is receiving services at the study facility
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description FAM-CARE FAM-CARE Two facility "clusters" (one hospital and one health center, with their filter clinics) will be randomized to initiate the FAM-CARE program (where all HIV-positive family members are seen together as a unit and receive care together) with viral load monitoring Control Standard of Care FAM-CARE Two "clusters" (one hospital and one health center, with their filter clinics) will be control standard-of care (usual practice) sites. Standard HIV care and treatment services, (drug resupply, clinical assessments etc.), including viral load monitoring, will be provided to adults and children in separate adult and pediatric clinics, even though they many be from the same family.
- Primary Outcome Measures
Name Time Method Proportion of HIV-positive children on ART virally suppressed 18 months after study enrollment. Proportion of HIV-positive children on ART with viral suppression (defined as HIV RNA copies/mL below the level of assay detection) and the proportion with HIV RNA \<1,000 copies/mL at 18 months after enrollment
Proportion of HIV-positive on ART virally unsuppressed 18 months after study enrollment. Proportion of HIV-positive children on ART with HIV RNA \>1000 copies/mL 18 months after enrollment into the study.
- Secondary Outcome Measures
Name Time Method Loss to follow-up 18 months after study enrollment Loss to follow-up (not seen in clinical care \>3 months)
Proportion HIV-positive children on ART virally suppressed (<1,000 copies/mL of HIV RNA) at 6 and 12 months after study enrollment 6 and 12 months after study enrollment Proportion of HIV-positive children on ART with viral suppression (defined as HIV RNA copies/mL below the level of assay detection) and HIV RNA \>1000 copies/mL
Acceptability of the FAM-CARE program based on individual interview responses 18 months after study enrollment Acceptability of the FAM-CARE program to caregivers and health care provider as measured from responses on individual interviews using a structured questionnaire
Factors associated with HIV viral suppression 18 months after study enrollment Individual and family factors associated with viral suppression.
ART initiation 18 months after study enrollment ART initiation in HIV-positive children not on ART at study entry
Trial Locations
- Locations (1)
Mbabane
🇸🇿Mbabane, Swaziland