- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT02139176
Assessing Strategies for Increasing Male Involvement in Malawi's Antenatal Program
In sub-Saharan Africa, engaging men in HIV prevention, care, and treatment has proven challenging. Along all steps of the HIV care-seeking cascade, men exhibit worse care-seeking behaviors than women. They are less likely to be tested for HIV, initiate combination antiretroviral therapy (cART), and be retained in cART care. Additionally, men rarely engage in the care of their female sex partners, even though couple care-seeking is associated with marked improvements in condom use within HIV-discordant couples. Option B+, Malawi's program for providing immediate, lifelong combination antiretroviral therapy (cART) to all HIV-infected pregnant women at the time of diagnosis, is an important entry-point for involving male partners in care.
This is a pilot randomized controlled trial (N=200 women) comparing two strategies of male partner involvement within the Option B+ program. In both arms (patient referral and contract referral) women will be encouraged to invite their male partners to accompany them to the clinic for couple HIV counseling and testing. In the contract referral arm, if the couple does not present within one week, the male partner will receive a home visit encouraging them to present to the clinic. We will compare the two arms for 1) uptake of couple HIV counseling and testing (cHCT), 2) uptake of cART for women, and 3) linkage to care for HIV-infected men. Results are expected to inform a larger trial and ultimately improve care-seeking in Malawi's HIV program.
Objective 1: Determine acceptability of male partner recruitment for cHTC within an Option B+ context. We will assess acceptability of eligible females to participate in this pilot RCT and reasons for non-participation.
Objective 2: Assess whether study arm (patient referral versus contract referral) is associated with cHTC uptake. We will conduct a pilot randomized controlled trial (RCT) of male partner recruitment. This study will contain two arms: patient referral and contract referral for uptake of cHTC (primary outcome).
Studieoversigt
Status
Betingelser
Intervention / Behandling
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
-
-
Central District
-
Lilongwe, Central District, Malawi
- Bwaila District Hospital Antenatal Unit
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
18 years old or 16-17 years old and married
- Pregnant
- Received a positive HIV-test within the last day
- Will be in Lilongwe for the next month
- Able and willing to give locator information for >1 male partner in the Bwaila District Hospital catchment area (either a mobile number, a physical address, or both)
Exclusion Criteria:
- Enrolled/enrolling in the PROMISE study
- Initially Presenting with a male sex partner
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Sundhedstjenesteforskning
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
---|---|
Aktiv komparator: Patient referral
Women are given an invitation to give to a male partner inviting them to come to the clinic for important pregnancy information
|
A patient agrees to recruit their partner using the invitation.
Andre navne:
|
Eksperimentel: contract referral
Same as control.
However, if the male partner does not present, a community worker will trace the partner in the community.
|
A patient agrees to recruit their partner using the invitation.
Andre navne:
A female partner signs a contract saying it is permissible for a community worker to trace a male sex partner in the community.
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
---|---|---|
Number of Women Who Came With Their Partners and Received Couple Counseling and Testing
Tidsramme: three months
|
Based on whether the female partner brings her male partner to the antenatal clinic for couple HIV counseling and testing (as recorded on study case report forms) as the primary measure of uptake.
We will compare time to couple HIV counseling and testing between groups using the Kaplan Meier method and a log rank test.
|
three months
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
---|---|---|
Female First Option B+ Follow-up Visit
Tidsramme: three months
|
It will be assessed whether the female participants return for their first Option B+ visit (using the clinic's routine Option B+ records).
The number retained will be compared.
|
three months
|
Male Linkage to Care
Tidsramme: one month from male presentation to the clinic
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It will be assessed whether newly diagnosed HIV-infected male partners are linked to care within one month of learning their HIV positive result with their partner.
This will be assessed from abstraction of routine clinic records at Martin Preuss Center.
|
one month from male presentation to the clinic
|
Samarbejdspartnere og efterforskere
Efterforskere
- Ledende efterforsker: Nora E Rosenberg, PhD, University of North Carolina, Chapel Hill
- Ledende efterforsker: Mina Hosseinipour, MD, University of North Carolina, Chapel Hill
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Andre undersøgelses-id-numre
- 13-3707
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