Home-based intervention to test and start (HITS) protocol: a cluster-randomized controlled trial to reduce HIV-related mortality in men and HIV incidence in women through increased coverage of HIV treatment.
Adolescent
Adult
Cluster Analysis
Computers, Handheld
Decision Support Techniques
Factor Analysis, Statistical
Female
HIV
HIV Infections
/ diagnosis
Home Care Services
Humans
Incidence
Male
Mass Screening
/ methods
Middle Aged
Motivation
Patient Acceptance of Health Care
Randomized Controlled Trials as Topic
South Africa
/ epidemiology
Young Adult
Counselling
Financial incentives
HIV
Home-based HIV testing
Linkage to care
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
19 Jul 2019
19 Jul 2019
Historique:
received:
19
06
2019
accepted:
03
07
2019
entrez:
21
7
2019
pubmed:
22
7
2019
medline:
15
10
2019
Statut:
epublish
Résumé
To realize the full benefits of treatment as prevention in many hyperendemic African contexts, there is an urgent need to increase uptake of HIV testing and HIV treatment among men to reduce the rate of HIV transmission to (particularly young) women. This trial aims to evaluate the effect of two interventions - micro-incentives and a tablet-based male-targeted HIV decision support application - on increasing home-based HIV testing and linkage to HIV care among men with the ultimate aim of reducing HIV-related mortality in men and HIV incidence in young women. This is a cluster randomized trial of 45 communities (clusters) in a rural area in the uMkhanyakude district of KwaZulu Natal, South Africa (2018-2021). The study is built upon the Africa Health Research Institute (AHRI)'s HIV testing platform, which offers annual home-based rapid HIV testing to individuals aged 15 years and above. In a 2 × 2 factorial design, individuals aged ≥15 years living in the 45 clusters are randomly assigned to one of four arms: i) a financial micro-incentive (food voucher) (n = 8); ii) male-targeted HIV specific decision support (EPIC-HIV) (n = 8); iii) both the micro incentives and male-targeted decision support (n = 8); and iv) standard of care (n = 21). The EPIC-HIV application is developed and delivered via a tablet to encourage HIV testing and linkage to care among men. A mixed method approach is adopted to supplement the randomized control trial and meet the study aims. The findings of this trial will provide evidence on the feasibility and causal impact of two interventions - micro-incentives and a male-targeted HIV specific decision support - on uptake of home-based HIV testing, linkage to care, as well as population health outcomes including population viral load, HIV related mortality in men, and HIV incidence in young women (15-30 years of age). This trial was registered on 28 November 2018 on, identifier https://clinicaltrials.gov/ .
Sections du résumé
BACKGROUND
BACKGROUND
To realize the full benefits of treatment as prevention in many hyperendemic African contexts, there is an urgent need to increase uptake of HIV testing and HIV treatment among men to reduce the rate of HIV transmission to (particularly young) women. This trial aims to evaluate the effect of two interventions - micro-incentives and a tablet-based male-targeted HIV decision support application - on increasing home-based HIV testing and linkage to HIV care among men with the ultimate aim of reducing HIV-related mortality in men and HIV incidence in young women.
METHODS/DESIGN
METHODS
This is a cluster randomized trial of 45 communities (clusters) in a rural area in the uMkhanyakude district of KwaZulu Natal, South Africa (2018-2021). The study is built upon the Africa Health Research Institute (AHRI)'s HIV testing platform, which offers annual home-based rapid HIV testing to individuals aged 15 years and above. In a 2 × 2 factorial design, individuals aged ≥15 years living in the 45 clusters are randomly assigned to one of four arms: i) a financial micro-incentive (food voucher) (n = 8); ii) male-targeted HIV specific decision support (EPIC-HIV) (n = 8); iii) both the micro incentives and male-targeted decision support (n = 8); and iv) standard of care (n = 21). The EPIC-HIV application is developed and delivered via a tablet to encourage HIV testing and linkage to care among men. A mixed method approach is adopted to supplement the randomized control trial and meet the study aims.
DISCUSSION
CONCLUSIONS
The findings of this trial will provide evidence on the feasibility and causal impact of two interventions - micro-incentives and a male-targeted HIV specific decision support - on uptake of home-based HIV testing, linkage to care, as well as population health outcomes including population viral load, HIV related mortality in men, and HIV incidence in young women (15-30 years of age).
TRIAL REGISTRATION
BACKGROUND
This trial was registered on 28 November 2018 on, identifier https://clinicaltrials.gov/ .
Identifiants
pubmed: 31324175
doi: 10.1186/s12889-019-7277-0
pii: 10.1186/s12889-019-7277-0
pmc: PMC6642506
doi:
Types de publication
Clinical Trial Protocol
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
969Subventions
Organisme : Medical Research Council
ID : MR/P024378/1
Pays : United Kingdom
Organisme : NIAID NIH HHS
ID : R01 AI124389
Pays : United States
Organisme : Department of Health
ID : RP-2017-08-ST2-008
Pays : United Kingdom
Organisme : NIH HHS
ID : R01- AI124389
Pays : United States
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