- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02752152
Counseling and Reminders for Regular HIV and STIs Screening (Napneung-1)
A Randomized Study to Compare Three Counseling Strategies and Evaluate the Efficacy of Reminders for Regular HIV, Hepatitis B and C, and Syphilis Testing
Counseling intervention:
Primary objective: to evaluate and compare, in at-risk populations, the efficacy of three different counseling methods in terms of propensity to come back for a HIV re-test. Secondary objectives: to evaluate and compare the efficacy of the counseling methods in terms of reported risk behavior and HIV knowledge as well as their acceptability and cost-effectiveness; describe the distribution of duration from HIV primary infection to detection; and estimate the prevalence of chronic hepatitis B and C, and syphilis in HIV-uninfected participants of targeted populations.
Reminder intervention Primary objective: to evaluate and compare, in at-risk individuals who require frequent testing, the efficacy of reminders in terms of propensity to come back for a HIV re-test within 7 months.
Secondary objective: to assess the cost-effectiveness of reminders.
The interim analyses have shown that that some strategies are better than the others and the Advisory Committee recommended to use only the most efficient strategies (Computer assisted counseling and Scheduling an appointment and sending reminder to clients).
In addition, CD4 cell count normal ranges in 30 HIV uninfected individuals in Thailand will be assessed. Transient elastometry (FibroScan) will be used to assess liver fibrosis in participants with and without viral hepatitis.
Study Overview
Status
Detailed Description
The study will be presented to clients, who will be asked to formally consent to participate. Clients residing or working in Thailand and able to communicate with the counselor will be eligible. Foreigners staying in Thailand for vacation or retirement will be excluded, except if presenting together with their partner who is otherwise eligible for the study. At each visit, participants will be proposed an appointment for a re-test. If they wish, the study team will send them reminders.
At the first visit, participants will be randomly assigned to one of three different methods for counseling on HIV, hepatitis B and C, and syphilis: standard face-to-face counseling, computer-assisted informational/educational counseling, or on-demand counseling (the counselor invites the participant to ask questions). Participants will then be randomly assigned to one of three reminder strategies: Appointment+reminder, Reminder only, or No appointment and no reminder.
At each visit, blood sample will be collected to test for HIV, hepatitis B and C, and syphilis. Laboratory examinations will be free of charge for all participants. After the blood draw, participants will be invited to complete a questionnaire to assess their knowledge, attitudes and practices with regard to HIV and other infections. Test results will then be provided. In case of confirmed HIV infection, participants will be provided with further counseling, CD4 cell count measurement and referral options for immediate treatment. Blood samples collected during the study for the diagnosis will be stored for determination of the Fiebig stage (duration since HIV primary infection), evaluation of transmitted HIV drug resistance (sequencing) and investigation of viral transmission networks.
In a substudy, we will compare liver fibrosis assessed by transient elastometry and serum biomarkers (i.e. APRI and FIB-4) in Napneung participants with HBsAg and those with anti-HCV antibodies, and compare the measures with that obtained in participants negative for these tests.
The interim analyses have shown that that some strategies are better than the others and the Advisory Committee recommended to use only the most efficient strategies (Computer assisted counseling and Scheduling an appointment and sending reminder to clients). Thus the accrual to the arms "No appointment, no reminder" and "Reminder only" has been discontinued on 12 January 2019.
Following the published of CD4 cell count normal ranges in HIV uninfected individuals in Thailand since 1997 (Vithayasai, Sirisanthana, Sakonwasun, & Suvanpiyasiri, 1997), It is unknown whether these norms have changed in relation to changes in nutritional status and lifestyle in young adults. We will assess the number of CD4 cells/mL in the blood of the first 30 HIV-uninfected female and the first 30 HIV-uninfected male clients aged less than 26 years to determine whether there is a trend for an increase in young people due to the changes in nutrition and lifestyle during the last decades. This sub-study will be conducted from 1 February 2019 to 31 January 2021.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Chiang Mai, Thailand, 50100
- Faculty of Associated Medical Sciences, Chiang Mai University
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Chiang Mai, Thailand
- MAP Foundation testing facility
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Chiang Rai, Thailand
- Special clinic of Chiangrai Prachanukroh Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Residing or working in Thailand
- Able to communicate with the counselor
- Adults (>= 18 years old)
Exclusion Criteria:
- Foreigners staying in Thailand for vacation or retirement, except if they are presenting together with their partner staying permanently in Thailand or working in Thailand
- Couples requesting a couple counseling session
- HIV-positive participants (based on the client declaration)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Computer-assisted counseling
Computer-assisted informational/educational interactive session followed by an interactive face-to-face session to discuss personal issues with a counselor as needed
|
The counselor opens the computer-assisted information/educational interactive counseling program on the tablet computer and invites the participant to use the program.
Has an appointment and receive reminders for further testing
Only receive reminders for further testing
No appointment and no reminders for further testing
|
Experimental: On-demand counseling
The counselor asks whether the participant has any questions
|
Has an appointment and receive reminders for further testing
Only receive reminders for further testing
No appointment and no reminders for further testing
The counselor only invites the participants to ask questions about HIV and other STIs.
|
Active Comparator: Standard counseling
Interactive face-to-face counseling session
|
Has an appointment and receive reminders for further testing
Only receive reminders for further testing
No appointment and no reminders for further testing
The counselor gives face-to-face general information/education
|
Experimental: Appointment + reminder
Make appointment and send SMS reminder
|
The counselor opens the computer-assisted information/educational interactive counseling program on the tablet computer and invites the participant to use the program.
Has an appointment and receive reminders for further testing
The counselor only invites the participants to ask questions about HIV and other STIs.
The counselor gives face-to-face general information/education
|
Experimental: Reminder only
Send SMS reminder only
|
The counselor opens the computer-assisted information/educational interactive counseling program on the tablet computer and invites the participant to use the program.
Only receive reminders for further testing
The counselor only invites the participants to ask questions about HIV and other STIs.
The counselor gives face-to-face general information/education
|
Active Comparator: No appointment and no reminder
No appointment and no SMS reminder sent
|
The counselor opens the computer-assisted information/educational interactive counseling program on the tablet computer and invites the participant to use the program.
No appointment and no reminders for further testing
The counselor only invites the participants to ask questions about HIV and other STIs.
The counselor gives face-to-face general information/education
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage of participants from at-risk populations coming for a HIV re-test
Time Frame: Within 7 months following the first visit
|
Number of participants having a re-test divided by number of at-risk participants
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Within 7 months following the first visit
|
Collaborators and Investigators
Investigators
- Principal Investigator: Gonzague Jourdain, MD. PhD, IRD
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Digestive System Diseases
- RNA Virus Infections
- Virus Diseases
- Infections
- Blood-Borne Infections
- Communicable Diseases
- Sexually Transmitted Diseases
- Liver Diseases
- Flaviviridae Infections
- Hepatitis, Viral, Human
- Hepadnaviridae Infections
- DNA Virus Infections
- Gram-Negative Bacterial Infections
- Bacterial Infections
- Bacterial Infections and Mycoses
- Enterovirus Infections
- Picornaviridae Infections
- Sexually Transmitted Diseases, Bacterial
- Spirochaetales Infections
- Treponemal Infections
- Hepatitis B
- Hepatitis
- Hepatitis A
- Hepatitis C
- Syphilis
Other Study ID Numbers
- Napneung-1
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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