- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04772469
Self-Test Strategies and Linkage Incentives to Improve ART and PrEP Uptake in Men
Study Overview
Status
Conditions
Detailed Description
In Aim 1, following the study pilot, community selection, and preparation the investigators will conduct a census/BMU registry verification in study communities to identify the population of men eligible for the study. The study will screen, recruit and enroll eligible men who give their informed consent to participate, then measure their close social networks identify network-central, highly-connected men ("promoters") and randomize their close social network (a cluster) to 1:1 intervention and control groups. Investigators will then conduct a baseline survey to collect socio demographic and baseline sexual behavior data among men in the close social networks. Following this baseline data collection, all promoters will be provided a training. Promoters in the intervention group will receive HIVST training, multiple HIVST for distribution to other men, and a small amount of remuneration. Promoters in the control group will receive basic HIV education and training about the study, and will be given vouchers that can be exchanged for HIV tests (standard or free HIVST kits) at nearby health facilities. Using follow-up survey data, investigators will test the hypothesis that a higher rate of HIV testing will be observed after 3 months among men in networks that receive the intervention compared to control.
In Aim 2, investigators will test whether network-central promoters can enhance linkage to ART and PrEP after HIV testing among men in their close social networks. Promoters in the Aim 1 intervention group will be asked to distribute information and transport vouchers for ART or PrEP when distributing HIV self-tests to men in their close social networks. Investigators will use clinic data to test the primary hypothesis that the intervention will result in higher rates of linkage to ART or PrEP (confirmatory testing and ART referral for positives, and PrEP screening for negatives). Investigators also will test the hypothesis that higher ART and PrEP uptake will be observed within 3 months (+ about one month) in the intervention group.
In Aim 3, investigators will measure 6 month VL and 6 month tenofovir levels using viral load testing and a novel point of care PrEP adherence assay (an antibody-based assay permitting measurement of tenofovir levels in urine) in study sites, and test the hypothesis that higher rates of virologic suppression will be observed in HIV-infected men, and PrEP adherence in un-infected men, in the intervention group. Viral load measurements will be conducted by drawing additional venous blood during routine blood draws scheduled for MOH viral load monitoring (as well as additional draws during scheduled appointments for those occurring outside of the annual VL testing standard of care window). PrEP adherence will be measured utilizing the study urine assay at 6 months. HIV treatment adherence will measured through adherence assessment during 3 and 6 routine clinic visits.
Across all aims, investigators will assess the pathways of intervention action using qualitative and mixed methods. Investigators will identify the mechanisms of action, and barriers and facilitators of the social network and incentives intervention implementation, using qualitative and mixed methods quantitative and qualitative assessments embedded in Aims 1, 2 and 3. The data collection approach will include in-depth interviews with participants in both groups, key informant interviews with network-central promoters, and focus group discussions with study participants stratified by HIV status and study group. Data will be collected at baseline and three follow-up periods corresponding to the timing of quantitative outcome measurements in Aims 1 through 3.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Siaya, Kenya
- Impact Research Development Organization
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adult (18 years or older)
- Male
- Working as a fisherman or fishing-related occupation
- Willing and able to provide informed consent for participation
- Not participating in another research study related to HIV testing, treatment and/or prevention
Exclusion Criteria:
- Younger than 18 years of age
- Female
- Included in another intervention study on HIV/AIDS
- Inadequate cognitive and/or hearing capacity to complete planned study procedures, at the discretion of the study team
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 |
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Experimental: Promoter training, multiple self-test kits, and incentives
Promoters in the intervention group will receive HIVST training, multiple HIVST for distribution to other men, and a small amount of remuneration (transport voucher) for themselves and to distribute to men in their networks.
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Participants will be given multiple Oraquick Advance HIV-1/2 test kits for testing themselves more frequently and for men in their social networks.
Use of small incentive voucher (~$5) to encourage linkage to confirmatory testing.
Messages will be motivational, will not include any identifying information and will include generic texts such as "maintain your good health", to cater for status-neutral language that can work for both HIV positive individuals taking ARVs, as well as HIV-negative individuals on PrEP who may need adherence support.
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No Intervention: Short training and referral for testing
Promoters in the control group will a short training on the basics of HIV prevention and treatment and will be encouraged to refer men in their networks for standard of care testing at the local health facilities- this may include HIV testing with a counselor or HIV self-test from the local health clinic, depending on what is available.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Self-reported HIV testing
Time Frame: Up to 3 months
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Proportion of participants who self-report HIV testing (yes/no) within the past 3 months, measured at 3-month follow-up.
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Up to 3 months
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Linkage to care or prevention
Time Frame: Up to 3 months
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For HIV-positive participants (care): the proportion of participants who obtained confirmatory HIV testing (yes/no), 3-months following self-reported HIV testing AND the proportion of participants who had an HIV clinic visit (yes/no), 3-months following confirmatory HIV testing. For HIV-negative participants (prevention): the proportion of participants who obtained confirmatory HIV testing (yes/no) 3-months following self-reported testing AND the proportion of participants who were evaluated for PrEP (yes/no), 3-months following confirmatory HIV testing. |
Up to 3 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Linkage to ART or to PrEP
Time Frame: Up to 3 months
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ART: Proportion of HIV-positive participants who initiate ART prescription (yes/no), 3-months following confirmatory testing and eligibility screening. PrEP: Proportion of PrEP-eligible HIV-negative participants who initiate PrEP prescription (yes/no), 3-months following confirmatory testing and eligibility screening. |
Up to 3 months
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Adherence to ART or PrEP
Time Frame: Up to 6 months
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ART: Proportion of HIV-positive participants who attain viral suppression (HIV RNA <400 c/mL), 6 months following ART initiation. PrEP: proportion of PrEP-taking HIV-negative participants who are adherent to PrEP (TFV levels of >= 1500 ng/mL) at 6 months following PrEP initiation. |
Up to 6 months
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HIV testing after 3 months
Time Frame: 3 to 6 months
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Confirmatory HIV testing uptake 3 to 6 months after intervention start
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3 to 6 months
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Harsha Thirumurthy, PhD, University of Pennsylvania
- Principal Investigator: Carol S Camlin, MPH, PhD, University of California, San Francisco
Publications and helpful links
General Publications
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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 (Actual)
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
- Pathologic Processes
- Blood-Borne Infections
- Lentivirus Infections
- Immune System Diseases
- Disease Attributes
- Slow Virus Diseases
- Urogenital Diseases
- Genital Diseases
- HIV Infections
- Infections
- Communicable Diseases
- Virus Diseases
- Acquired Immunodeficiency Syndrome
- Immunologic Deficiency Syndromes
- Sexually Transmitted Diseases
- RNA Virus Infections
- Sexually Transmitted Diseases, Viral
- Retroviridae Infections
Other Study ID Numbers
- 19-28205
- 1R01MH120176 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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