AfriREP

Efficacy of an enhanced linkage to HIV care intervention at improving linkage to HIV care and achieving viral suppression following home-based HIV testing in rural Uganda: study protocol for the Ekkubo/ PATH cluster randomized controlled trial

Show simple item record

dc.contributor.author Kiene, Susan M.
dc.contributor.author Kalichman, Seth C.
dc.contributor.author Sileo, Katelyn M.
dc.contributor.author Menzies, Nicolas A.
dc.contributor.author Naigino, Rose
dc.contributor.author Lin, Chii-Dean
dc.contributor.author Bateganya, Moses H.
dc.contributor.author Lule, Haruna
dc.contributor.author Wanyenze, Rhoda K.
dc.date.accessioned 2019-07-18T11:02:04Z
dc.date.available 2019-07-18T11:02:04Z
dc.date.issued 2017
dc.identifier.uri http://awdflibrary.org:8080/xmlui/handle/123456789/881
dc.description.abstract Background: Though home-based human immunodeficiency virus (HIV) counseling and testing (HBHCT) is implemented in many sub-Saharan African countries as part of their HIV programs, linkage to HIV care remains a challenge. The purpose of this study is to test an intervention to enhance linkage to HIV care and improve HIV viral suppression among individuals testing HIV positive during HBHCT in rural Uganda. Methods: The PATH (Providing Access To HIV Care)/Ekkubo Study is a cluster-randomized controlled trial which compares the efficacy of an enhanced linkage to HIV care intervention vs. standard-of-care (paper-based referrals) at achieving individual and population-level HIV viral suppression, and intermediate outcomes of linkage to care, receipt of opportunistic infection prophylaxis, and antiretroviral therapy initiation following HBHCT. Approximately 600 men and women aged 18-59 who test HIV positive during district-wide HBHCT in rural Uganda will be enrolled in this study. Villages (clusters) are pair matched by population size and then randomly assigned to the intervention or standard-of-care arm. Study teams visit households and participants complete a baseline questionnaire, receive HIV counseling and testing, and have blood drawn for HIV viral load and CD4 testing. At baseline, standard-of-care arm participants receive referrals to HIV care including a paper-based referral and then receive their CD4 results via home visit 2 weeks later. Intervention arm participants receive an intervention counseling session at baseline, up to three follow-up counseling sessions at home, and a booster session at the HIV clinic if they present for care. These sessions each last approximately 30 min and consist of counseling to help clients: identify and reduce barriers to HIV care engagement, disclose their HIV status, identify a treatment supporter, and overcome HIV-related stigma through links to social support resources in the community. Participants in both arms complete interviewer-administered questionnaires at six and 12 months follow-up, HIV viral load and CD4 testing at 12 months follow-up, and allow access to their medical records. Discussion: The findings of this study can inform the integration of a potentially cost-effective approach to improving rates of linkage to care and HIV viral suppression in HBHCT. If effective, this intervention can improve treatment outcomes, reduce mortality, and through its effect on individual and population-level HIV viral load, and decrease HIV incidence. en_US
dc.language.iso en en_US
dc.subject Home-based HIV counseling and testing (HBHCT), Linkage to care, HIV viral suppression, Health behavior intervention, Cluster-randomized controlled trial, Uganda en_US
dc.title Efficacy of an enhanced linkage to HIV care intervention at improving linkage to HIV care and achieving viral suppression following home-based HIV testing in rural Uganda: study protocol for the Ekkubo/ PATH cluster randomized controlled trial en_US
dc.type Article en_US


Files in this item

This item appears in the following Collection(s)

Show simple item record

Search AfriREP


Browse

My Account