Effectiveness of Peer Navigation and Contingency Management on Retention in HIV Care
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 579
- 试验地点
- 6
- 主要终点
- Change in HIV RNA viral load suppression and medication adherence over 12 months
研究概览
简要总结
Consistent treatment with anti-retroviral therapy (ART) suppresses viral load (VL), prolonging life and improving quality of life for HIV+ persons. Suppressing VL benefits communities by reducing transmission to others. Mere availability of ART and care, however, is insufficient; the benefits of ART depend upon HIV+ persons' continuous visits to the health care provider, regular monitoring and regular delivery of medications, - known as retention in HIV care. In spite of national efforts, up to a quarter of HIV+ persons, especially low-income minorities are out of care. Innovative interventions are therefore urgently needed to maximize engagement and retention in HIV care, self-reported adherence, as well as HIV-1 RNA viral load suppression. In pursuit of these aims, the proposed study will assess outcomes of the following interventions in comparison to usual care: 1) contingency management (CM) only; 2) peer navigation (PN) only; and 3) a combined approach that integrates both CM and PN (CA) which the investigators hypothesize to be most effective in improving HIV clinical outcomes.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 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
- •Diagnosed HIV+
- •Age 18 years or older
- •English or Spanish speaking
- •Residence in Los Angeles County
- •prescribed ART in prior 24 months
- •< 3 visits in prior 12 months or have detectable viral load, as identified in the Ryan White CaseWatch database
排除标准
- •Not meeting any of the criteria identified above
研究组 & 干预措施
Contingency Management only
Participants assigned to this arm will receive payments for attending regular HIV medical appointments at the clinic and filling prescribed HIV medications at the pharmacy
干预措施: Contingency Management (Behavioral)
Peer Navigation only
Participants in this arm will be assigned a peer navigator to assist them in accessing and remaining in HIV care
干预措施: Peer Navigation (Behavioral)
Combined Contingency Management and Peer Navigation
Participants in this arm will be assigned a peer navigator to assist them in accessing and remaining in HIV care and will be eligible to receive incentives for attending HIV care visits/refilling prescriptions.
干预措施: Combined Contingency Management and Peer Navigation (Behavioral)
Usual care
Participants in this arm will receive the care that they would usually get in their clinic in the absence of this study.
结局指标
主要结局
Change in HIV RNA viral load suppression and medication adherence over 12 months
时间窗: Basline, follow-ups at month 2, and 12
Using the same design, to examine the effects of the PN, CM and, CA interventions on HIV RNA viral load suppression and self-reported adherence
Change in retention-in-care behaviors over 12 months
时间窗: Basline, follow-ups at month 2, 6, 12
Using a 2x2 factorial design, to examine the effect of the three interventions -- peer navigation, contingency management, combined approach and usual care -- and evaluate how well they improve retention in HIV care
次要结局
- Cost effectiveness(5 years)