Improving Engagement to HIV Prevention and Care in North West, South Africa
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 756
- 试验地点
- 2
- 主要终点
- Retention in Care - ART Eligible (Participants Eligible for ART Who Initiated ART and Who Remain on Treatment)
研究概览
简要总结
This study will evaluate the efficacy of two strategies for enhancing overall preventive behaviors, retention in HIV care, and adherence to medication for HIV positive individuals in South Africa: short message service (SMS) text messaging and peer navigation services.
详细描述
Treatment-as-prevention represents a game changing potential to stem further HIV transmission by ensuring that infected individuals are tested, linked to care, retained in care, and adherent to their regimens. Little is known, however, about the most feasible and cost-effective means to promote overall engagement in care coupled with behavioral risk reduction for HIV positive individuals in South Africa. For this reason, the study proposes to first assess what engagement in care activities are underway in select clinics in the Bojanala Platinum District, North West Province, South Africa, and will then implement and evaluate the feasibility, acceptability, and potential efficacy of two strategies for enhancing overall preventive behaviors, retention in HIV care and adherence to medication. The first strategy will employ automated text message reminders to encourage patients to return for needed care, adhere to their antiretroviral therapy (ART) regimens, and practice safer sex and other risk reduction behaviors. This approach also includes designation of a retention, adherence, and prevention monitor to supervise the system. A second strategy builds on the first model, including the automated text message system, but also utilizes peer navigator-provider teams to serve as point people for care engagement. Peer navigators will work with providers to introduce patients to care and help them establish a care and prevention plan. They will also check in with patients to discuss and support resolution of challenges to engaging in care, adhering to drug regimens, and reducing transmission risk behavior.
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
- 否
入选标准
- •HIV positive (diagnosed within the last 12 months prior to study/patient contact)
- •Has access to a mobile phone
- •Willing to receive and respond to text messages and calls from clinic and study staff (all arms)
- •Willing to communicate and meet with PN (PN arm)
- •Willing to meet with study staff for survey at study start, 6 months, and 12 months (all arms)
- •regard study clinic area as the regular clinic for accessing healthcare
排除标准
- •First tested positive over 12 months prior to recruitment
- •Under the age of 18
- •Unable to give informed consent
- •Unable to read basic English and with no one to read study sms to participant
- •Principally accesses care through a clinic not in the study
- •Planning to permanently move away from the area served by the clinic within next 6 months (following enrollment)
研究组 & 干预措施
Standard of Care
Participants are administered baseline, 6 month, and 12 month questionnaires and provided with the study incentive (mobile phone airtime) only. This group will not receive any additional engagement to care intervention.
SMS text message
Participants are administered baseline, 6 month, and 12 month questionnaires and provided with the study incentive (mobile phone airtime). In addition, they receive automated bi-weekly behavioral text messages aimed at improving health and reducing transmission risk and also automated bi-weekly "check-in" text messages that will trigger a phone call from clinic staff if the participant reports not being well.
干预措施: SMS text message (Behavioral)
SMS text message + Peer Navigation
Participants are administered baseline, 6 month, and 12 month questionnaires and provided with the study incentive (mobile phone airtime). In addition, they receive automated bi-weekly behavioral text messages aimed at improving health and reducing transmission risk and also bi-weekly contact from an HIV-positive peer who provides personalized support and with health or other service systems navigation assistance.
干预措施: SMS text message + Peer Navigation (Behavioral)
结局指标
主要结局
Retention in Care - ART Eligible (Participants Eligible for ART Who Initiated ART and Who Remain on Treatment)
时间窗: 12 months
Participants eligible for ART who initiated ART and who remain on treatment 12 months from enrollment. Retention in care at 12 months is defined as at least 4 clinical care visits with less than 4 months between each visit.
Adherence to ART - Objective (Viral Load Test Results <400 Copies/mL)
时间窗: 12 months
Viral load test results \<400 copies/mL (consistent with current and correct adherence to ART)
Adherence to ART - Subjective (Self-reported Ability to Take ART as Prescribed in Last Month)
时间窗: 12 months
Self-reported ability to take ART as prescribed in last month, assessed at 12 months from enrollment. Considered compliant if reported "very good" or "excellent" adherence.
Timely Antiretroviral Therapy (ART) Initiation (Participants Eligible for ART Who Initiate Treatment Within 3 Months of Diagnosis)
时间窗: 3 months
Participants eligible for ART who initiate treatment within 3 months of diagnosis
Retention in Care - Non-ART (Participants Who Return for Repeat CD4 Testing Within 12 Months of Diagnosis)
时间窗: 12 months
Participants who return for repeat CD4 testing within 12 months of diagnosis
Linkage to Care - Participants Who Received Cluster of Differentiation 4 (CD4) T-cell Count Test Result Within 3 Months of Testing HIV-positive (Binary)
时间窗: 3 months
Participants who received CD4 count test result within 3 months of testing HIV-positive (binary)
次要结局
未报告次要终点