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Assisted Partner Notification to Augment HIV Treatment and Prevention in Kenya (APS)

6 aprile 2017 aggiornato da: Carey Farquhar, University of Washington

The main purpose of this implementation science study is to find out if providing aPS at 18 different Ministry of Health (MOH) VCT clinics in Kenya works and is cost-effective. This would enable co-investigators in the Kenyan MOH to justify funding to scale-up these services.

The primary aim of the study is to find out whether providing aPS to sexual partners of newly tested HIV-infected individuals can result in more sexual partners getting counseled and HIV tested and linked to HIV care programs for initiation of ART if appropriate. The investigators hypothesize that aPS will increase rates of case-finding, linkages to care, and ART initiation and will not result in social harm.

The second aim is whether aPS is cost-effective in the Kenyan setting. The investigators will estimate how much it costs (when compared to standard methods) to identify and link HIV-infected persons into care. The investigators will also determine how successful aPS is at preventing future HIV transmission events and other outcomes associated with untreated HIV infection. The investigators hypothesize that HIV prevalence among partners in the immediate aPS arm will be high enough to make this approach cost-effective from the payer and societal perspective.

Finally, with the Kenya MOH, the investigators want to establish a nationwide monitoring system to evaluate why Kenyans are testing for HIV. In the future, when aPS is rolled out nationally, this will help Kenyan public health officials define the contribution of aPS to HIV case-finding. The investigators hypothesize that the proportion of newly tested HIV-infected individuals who report testing because of known exposure to a person with HIV will represent a significant proportion of new cases and the investigators will be able to identify places in Kenya where aPS will have the greatest impact on HIV treatment and prevention.

Panoramica dello studio

Stato

Completato

Condizioni

Descrizione dettagliata

Diagnosing HIV soon after infection can benefit individuals and also has important public health benefits. It has been shown that starting antiretroviral therapy (ART) before HIV has progressed results in a better response to treatment and gives the person a better chance of long-term survival with HIV. Treating HIV can also reduce the risk that someone will transmit HIV to his or her sexual partners. The first step in achieving these individual and population level benefits is testing people for HIV. Unfortunately, in many parts of the world, including Kenya where we plan to conduct this study, many people are not tested regularly and do not know that they are infected. This study involves providing a public health service, notification of an exposure to a communicable disease and HIV testing, to sexual partners of those who test HIV-positive at voluntary counseling and testing (VCT) clinics in Kenya. Sexual partners are identified voluntarily by the person who tests at the VCT. A public health provider then goes to the home of the sexual partners to offer them HIV counseling and testing. This process is called provision of assisted partner services (aPS).

We propose a cluster randomized clinical trial which will be conducted in collaboration with the Kenya Ministry of Health (MOH) at 18 rural and urban voluntary counseling and testing (VCT) facilities across Kenya. Proposed activities will assess the effectiveness and cost-effectiveness of providing aPS, improve capacity for program implementation in Kenya, and lay the foundation for evaluating the program's impact at the national level.

Tipo di studio

Interventistico

Iscrizione (Effettivo)

2424

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

      • Kiambu, Kenya
        • Karuri VCT
      • Kiambu, Kenya
        • Kiambu Hospital VCT
      • Kiambu, Kenya
        • Kirwara VCT
      • Kisumu, Kenya
        • Chulaimbo Health Centre
      • Kisumu, Kenya
        • Joo Trh Vct
      • Kisumu, Kenya
        • Kisumu East District Hospital
      • Kisumu, Kenya
        • Kombewa VCT
      • Maseno, Kenya
        • Maseno Mission
      • Nairobi, Kenya
        • Baba Dogo VCT
      • Nairobi, Kenya
        • Casino VCT
      • Nairobi, Kenya
        • Huruma Lions
      • Nairobi, Kenya
        • Kariobangi VCT
      • Nairobi, Kenya
        • Kenyatta National Hospital (KNH) VCT
      • Nairobi, Kenya
        • Mama Lucy Kibaki VCT
      • Nairobi, Kenya
        • Mbagathi VCT
      • Nairobi, Kenya
        • Pumwani VCT
      • Siaya, Kenya
        • Abidha Health Centre
      • Siaya, Kenya
        • Ongielo Health Centre

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  • Written informed consent is required of all participants. All participants must be 18 years or older.
  • Index case participants must be HIV-seropositive, and willing and able to provide locator information for sexual partners in the past three years.

Exclusion Criteria:

  • Index cases will be excluded from participation if they are pregnant, or have reported intimate partner violence during the last month. There is no exclusion criteria for partner participants.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Ricerca sui servizi sanitari
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Nessun intervento: Delayed aPS
Sperimentale: Immediate aPS
Assisted-partner notification services (aPS) is a public health service which notifies the partners of those who test positive for a communicable disease of their exposure.
Altri nomi:
  • Partner notification services
  • Assisted partner services

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Number of partners testing for HIV
Lasso di tempo: 6 week period following index case enrollment
The number of partners of an index participant that were tested for HIV (offset will be the number of partners with locator information provided by the index participant).
6 week period following index case enrollment
Newly tested HIV-infected partners
Lasso di tempo: 6 week period following index case enrollment
The number of partners of an index participant identified as HIV-infected (offset will be the number of partners of that index participant who were HIV tested).
6 week period following index case enrollment
Number of partners linking to HIV care
Lasso di tempo: 6 week period following index case enrollment
The number of partners of an index participant who were linked to HIV care (offset will be the number of partners of an index participant identified as HIV-infected and analysis will be limited to index participants with at least one HIV-infected partner.)
6 week period following index case enrollment

Misure di risultato secondarie

Misura del risultato
Lasso di tempo
Incremental cost-effectiveness from payer and societal perspectives
Lasso di tempo: 6 week period following index case enrollment
6 week period following index case enrollment
Proportion of individuals with newly diagnosed HIV infection who report testing because of known exposure to a person with HIV
Lasso di tempo: 6 week period after index case enrollment
6 week period after index case enrollment
Costs of identifying >1 partner per index case
Lasso di tempo: 6 week period after index case enrollment
6 week period after index case enrollment

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Investigatori

  • Investigatore principale: Carey Farquhar, MD, MPH, University of Washington
  • Cattedra di studio: Peter Cherutich, MBChB, MPH, Kenya Ministry of Health
  • Cattedra di studio: Matthew Golden, MD, MPH, University of Washington

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 giugno 2012

Completamento primario (Effettivo)

1 agosto 2015

Completamento dello studio (Effettivo)

1 agosto 2015

Date di iscrizione allo studio

Primo inviato

7 giugno 2012

Primo inviato che soddisfa i criteri di controllo qualità

8 giugno 2012

Primo Inserito (Stima)

11 giugno 2012

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

10 aprile 2017

Ultimo aggiornamento inviato che soddisfa i criteri QC

6 aprile 2017

Ultimo verificato

1 aprile 2017

Maggiori informazioni

Termini relativi a questo studio

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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