- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05905640
One-stop PrEP Care Pathway to Simplify PrEP Delivery in Kenya: The One-Stop PrEP Care Project
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Zarna Marfatia
- Phone Number: 2065203866
- Email: zarnam@uw.edu
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- ≥15 years of age
- Accessing PrEP services at implementing clinics.
- Eligible for PrEP per Kenya national guidelines
For in-depth and key delivery informant interviews
- Able and willing to provide consent
- Provides services at participating clinics (healthcare providers)
- Key policy maker
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Control arm- Usual PrEP care pathway
At clinics that will serve as contemporaneous control clinics, eligible persons will receive PrEP according to the current client flow, which typically involves multiple room consultations.
Quality improvement strategies will be promoted throughout the implementation period.
|
|
Other: Intervention Arm- One Stop PrEP care pathway
In a one-stop arm, the number of client consultation rooms in the PrEP care pathway will be reduced to a single consultation room.
All core PrEP services that include HIV testing, risk assessment, clinical review PrEP initiation, prescription, dispensing, and follow-up will be performed in a one-stop consultation with a single provider.
Quality improvement strategies will be promoted throughout the implementation period.
|
All core PrEP services that include HIV testing, risk assessment, clinical review PrEP initiation, prescription, dispensing, and follow-up will be performed in a one-stop consultation with a single provider.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
PrEP initiation
Time Frame: Years 2-4 of the study, up to 36 months.
|
PrEP initiation will be measured by client start of PrEP use documented on the ministry of health (MOH) tools.
Data will be abstracted from MOH tools by project dedicated staff from up to 2400 persons newly initiating PrEP at the participating clinics.
|
Years 2-4 of the study, up to 36 months.
|
PrEP continuation
Time Frame: up to 12 months of PrEP use.
|
PrEP continuation will determined by clinic visit attendance and pharmacy PrEP refills records obtained by abstraction of MOH clinic records.
|
up to 12 months of PrEP use.
|
PrEP adherence
Time Frame: Years 2-4 of the study, up to 36 months.
|
PrEP adherence will be measured objectively by quantification of drug levels in dried blood spots obtained at random subset visits from clients returning for PrEP refills.
|
Years 2-4 of the study, up to 36 months.
|
Acceptability
Time Frame: Throughout the study period, up to 36 months
|
Acceptability will be determined as the perception among clients, providers, and stakeholder that one-stop PrEP services is agreeable to them.
Mixed methods assessments, including user and provider surveys and qualitative interviews with users and providers will be utilized to measure acceptability.
The Proctors implementation framework will be utilized to organize outcomes and to understand acceptability of one-stop and quality improvement measures at the user, clinic, and provider level.
Investigators will comprehensively triangulate all data sources to understand how system, provider, and client factors interact to influence adoption.
|
Throughout the study period, up to 36 months
|
Adoption
Time Frame: Throughout the study period, up to 36 months
|
Adoption will be determined as the proportion and characteristics of facilities adopting one-stop services.
Mixed methods assessments, including provider surveys and qualitative interviews with users and providers will be utilized to measure adoption.
The Proctors implementation framework will be utilized to organize outcomes and to understand adoption of one-stop and quality improvement measures at the clinic and provider level.
Investigators will comprehensively triangulate all data sources to understand how system, provider, and client factors interact to influence adoption.
|
Throughout the study period, up to 36 months
|
Fidelity
Time Frame: Throughout the study period, up to 36 months
|
Fidelity will be defined as the degree to which one-stop pathway and quality improvement measures are implemented as planned.
Checklists and technical assistant reports will be used to study how implementation of one-stop pathway and quality improvement measures are implemented per protocol at provider and clinic level.
Investigators will comprehensively triangulate all data sources to understand how system, provider, and client factors interact to influence adoption.
|
Throughout the study period, up to 36 months
|
Total client wait time and staff time spent on PrEP services
Time Frame: Throughout the study period, up to 36 months
|
Efficiency will be defined as client wait time and staff time spent on PrEP services.
Time will be done by observing at least 50 clinical visits per arm to assess wait time and staff time spent on counseling, HIV testing, clinical review, and PrEP provision
|
Throughout the study period, up to 36 months
|
Satisfaction with services
Time Frame: Throughout the study period, up to 36 months
|
Satisfaction will be defined ad fulfillment or happiness with one-stop service experience.
Within the program we will use cross-sectional quantitative exit surveys administered to random clients at clinic to understand quality of care services and satisfaction with services.
|
Throughout the study period, up to 36 months
|
Sustainability
Time Frame: up to 12 months after technical assistance support is scaled back
|
Sustainability will be defined as the number of clinics using one-stop at 6, 12 months after TA. Checklists and technical assistant reports will be used to document implementation of one-stop after technical assistance support is scaled back The Proctors implementation framework will be use organize implementation outcomes. Investigators will comprehensively triangulate all data sources to understand how system, provider, and client factors interact to influence continuation of PrEP. |
up to 12 months after technical assistance support is scaled back
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incremental cost of one-stop PrEP services, including costs averted, and reduced client wait times.
Time Frame: up to 36 months.
|
Micro-costing studies will be conducted during the implementation of one-stop PrEP delivery in intervention clinics as well as the current practice arm using activity-based approaches for costs incurred (start-up activities, clinic-wide training, recruitment, PrEP service delivery, including HIV testing, PrEP drugs, STI treatment, creatinine testing, and follow-up) and direct program costs averted (health costs saved by averting HIV infections, personnel costs averted as result of providing PrEP in one stop).
|
up to 36 months.
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Kenneth Mugwanya, MBChB, MS, PhD, University of Washington
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
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
- RNA Virus Infections
- Virus Diseases
- Infections
- Blood-Borne Infections
- Communicable Diseases
- Sexually Transmitted Diseases, Viral
- Sexually Transmitted Diseases
- Lentivirus Infections
- Retroviridae Infections
- Immunologic Deficiency Syndromes
- Immune System Diseases
- Urogenital Diseases
- Genital Diseases
- HIV Infections
Other Study ID Numbers
- STUDY00015873
- R01MH129234-01A1 (U.S. NIH Grant/Contract)
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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