The impact of community-based integrated HIV and sexual and reproductive health services for youth on population-level HIV viral load and sexually transmitted infections in Zimbabwe: protocol for the CHIEDZA cluster-randomised trial.

HIV Zimbabwe community sexual and reproductive health youth

Journal

Wellcome open research
ISSN: 2398-502X
Titre abrégé: Wellcome Open Res
Pays: England
ID NLM: 101696457

Informations de publication

Date de publication:
2022
Historique:
accepted: 25 10 2023
medline: 2 1 2024
pubmed: 2 1 2024
entrez: 1 1 2024
Statut: epublish

Résumé

Youth have poorer HIV-related outcomes when compared to other age-groups. We describe the protocol for a cluster randomised trial (CRT) to evaluate the effectiveness of community-based, integrated HIV and sexual and reproductive health services for youth on HIV outcomes. The CHIEDZA trial is being conducted in three provinces in Zimbabwe, each with eight geographically demarcated areas (clusters) (total 24 clusters) randomised 1:1 to standard of care (existing health services) or to the intervention. The intervention comprises community-based delivery of HIV services including testing, antiretroviral therapy, treatment monitoring and adherence support as well as family planning, syndromic management of sexually transmitted infections (STIs), menstrual health management, condoms and HIV prevention and general health counselling. Youth aged 16-24 years living within intervention clusters are eligible to access CHIEDZA services. A CRT of STI screening (chlamydia, gonorrhoea and trichomoniasis) is nested in two provinces (16 of 24 clusters). The intervention is delivered over a 30-month period by a multidisciplinary team trained and configured to provide high-quality, youth friendly services.Outcomes will be ascertained through a population-based survey of 18-24-year-olds. The primary outcome is HIV viral load <1000 copies/ml in those living with HIV and proportion who test positive for STIs (for the nested trial). A detailed process and cost evaluation of the trial will be conducted. The trial protocol was approved by the Medical Research Council of Zimbabwe, the Biomedical Research and Training Institute Institutional Review Board and the London School of Hygiene & Tropical Medicine Research Ethics Committee. Results will be submitted to open-access peer-reviewed journals, presented at academic meetings and shared with participating communities and with national and international policy-making bodies. https://clinicaltrials.gov/: NCT03719521.

Sections du résumé

Background UNASSIGNED
Youth have poorer HIV-related outcomes when compared to other age-groups. We describe the protocol for a cluster randomised trial (CRT) to evaluate the effectiveness of community-based, integrated HIV and sexual and reproductive health services for youth on HIV outcomes.
Protocol UNASSIGNED
The CHIEDZA trial is being conducted in three provinces in Zimbabwe, each with eight geographically demarcated areas (clusters) (total 24 clusters) randomised 1:1 to standard of care (existing health services) or to the intervention. The intervention comprises community-based delivery of HIV services including testing, antiretroviral therapy, treatment monitoring and adherence support as well as family planning, syndromic management of sexually transmitted infections (STIs), menstrual health management, condoms and HIV prevention and general health counselling. Youth aged 16-24 years living within intervention clusters are eligible to access CHIEDZA services. A CRT of STI screening (chlamydia, gonorrhoea and trichomoniasis) is nested in two provinces (16 of 24 clusters). The intervention is delivered over a 30-month period by a multidisciplinary team trained and configured to provide high-quality, youth friendly services.Outcomes will be ascertained through a population-based survey of 18-24-year-olds. The primary outcome is HIV viral load <1000 copies/ml in those living with HIV and proportion who test positive for STIs (for the nested trial). A detailed process and cost evaluation of the trial will be conducted.
Ethics and Dissemination UNASSIGNED
The trial protocol was approved by the Medical Research Council of Zimbabwe, the Biomedical Research and Training Institute Institutional Review Board and the London School of Hygiene & Tropical Medicine Research Ethics Committee. Results will be submitted to open-access peer-reviewed journals, presented at academic meetings and shared with participating communities and with national and international policy-making bodies.
Trial Registration UNASSIGNED
https://clinicaltrials.gov/: NCT03719521.

Identifiants

pubmed: 38162283
doi: 10.12688/wellcomeopenres.17530.2
pmc: PMC10755263
doi:

Banques de données

ClinicalTrials.gov
['NCT03719521']

Types de publication

Journal Article

Langues

eng

Pagination

54

Informations de copyright

Copyright: © 2023 Dziva Chikwari C et al.

Déclaration de conflit d'intérêts

No competing interests were disclosed.

Auteurs

Chido Dziva Chikwari (C)

Biomedical Research and Training Institute, Harare, Zimbabwe.
MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.

Ethel Dauya (E)

Biomedical Research and Training Institute, Harare, Zimbabwe.

Tsitsi Bandason (T)

Biomedical Research and Training Institute, Harare, Zimbabwe.

Mandikudza Tembo (M)

Biomedical Research and Training Institute, Harare, Zimbabwe.
MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.

Constancia Mavodza (C)

Biomedical Research and Training Institute, Harare, Zimbabwe.
Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.

Victoria Simms (V)

Biomedical Research and Training Institute, Harare, Zimbabwe.
MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.

Constance Rs Mackworth-Young (CR)

Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.

Tsitsi Apollo (T)

AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe.

Chris Grundy (C)

MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.

Helen Weiss (H)

MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.

Katharina Kranzer (K)

Biomedical Research and Training Institute, Harare, Zimbabwe.
Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany.

Tino Mavimba (T)

Ardent Creative, Harare, Zimbabwe.

Pitchaya Indravudh (P)

Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.

Aoife Doyle (A)

Biomedical Research and Training Institute, Harare, Zimbabwe.
MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.

Owen Mugurungi (O)

AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe.

Anna Machiha (A)

AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe.

Sarah Bernays (S)

Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.
School of Public Health, University of Sydney, Sydney, Australia.

Joanna Busza (J)

Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.

Bernard Madzima (B)

National AIDS Council, Harare, Zimbabwe.

Fern Terris-Prestholt (F)

Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.

Ona McCarthy (O)

Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK.

Richard Hayes (R)

MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.

Suzanna Francis (S)

MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.

Rashida A Ferrand (RA)

Biomedical Research and Training Institute, Harare, Zimbabwe.
Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.

Classifications MeSH