ENGAGE4HEALTH: A Combination Intervention Strategy for Linkage and Retention in Mozambique

NCT ID: NCT01930084

Last Updated: 2017-02-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

2004 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-04-30

Study Completion Date

2016-07-31

Brief Summary

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Purpose: To compare the effectiveness of a combination intervention strategy (CIS), consisting of point of care (POC) CD4+ testing immediately following HIV diagnosis and accelerated ART initiation for eligible participants delivered by facility personnel, and cellular appointment reminders delivered by study personnel, to the standard of care (SOC) on linkage to and retention in HIV care at 12 months among adults testing positive for HIV in Mozambique. Additionally, the protocol will assess the incremental effectiveness of CIS+ non-cash financial incentives (FI) compared to CIS without FI on study outcomes.

Detailed Description

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Design: Two-arm cluster site-randomized trial with a pre-post intervention two-sample design nested in the intervention arm.

Study Population: The study population is any adult who tests HIV positive at the HIV counseling and testing points participating in this study. The study unit (SU), the level of randomization for the study, includes specific HIV counseling and testing points at primary health care clinics and the HIV care and treatment services located in the same health facility. A total of 10 SU will be included.

Sample Size: A total of 2,250 adults from the 10 study units will be included in the study, 750 in the SOC arm, 750 receiving CIS without FI and 750 receiving CIS+FI.

Participants will be enrolled and followed for 12 months after enrollment.

Conditions

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HIV

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Combination intervention + incentives

1. Point of care CD4+ after HIV diagnosis
2. Accelerated ART initiation
3. SMS appointment reminders
4. Non-cash financial incentives (FI)

Group Type EXPERIMENTAL

Point of care CD4+ after HIV diagnosis

Intervention Type OTHER

Point of care (POC) CD4+ testing immediately following HIV diagnosis

Accelerated ART initiation

Intervention Type OTHER

Accelerated ART initiation for eligible participants delivered by facility personnel

SMS appointment reminders

Intervention Type BEHAVIORAL

Cellular appointment reminders delivered by study personnel

Non-cash Financial Incentives

Intervention Type OTHER

Non-cash Financial Incentives

Combination intervention strategy(CIS)

1. Point of care (POC) CD4+ after HIV diagnosis
2. Accelerated ART initiation
3. SMS appointment reminders

Group Type EXPERIMENTAL

Point of care CD4+ after HIV diagnosis

Intervention Type OTHER

Point of care (POC) CD4+ testing immediately following HIV diagnosis

Accelerated ART initiation

Intervention Type OTHER

Accelerated ART initiation for eligible participants delivered by facility personnel

SMS appointment reminders

Intervention Type BEHAVIORAL

Cellular appointment reminders delivered by study personnel

Standard of care (SOC)

Standard of care, no intervention

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Point of care CD4+ after HIV diagnosis

Point of care (POC) CD4+ testing immediately following HIV diagnosis

Intervention Type OTHER

Accelerated ART initiation

Accelerated ART initiation for eligible participants delivered by facility personnel

Intervention Type OTHER

SMS appointment reminders

Cellular appointment reminders delivered by study personnel

Intervention Type BEHAVIORAL

Non-cash Financial Incentives

Non-cash Financial Incentives

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* 18 years of age or older
* Testing HIV positive at the largest-volume HIV point of testing (other than prevention of mother-to-child transmission or tuberculosis) at SU with written proof of test result
* Agreeing to be referred to the HIV care services associated with the SU
* Agreeing to provide locator information
* Agreeing to adhere to study procedures, including a baseline interview, interviews 1 and 12 months after study enrollment, and extraction of data from the HIV care and treatment electronic database
* Able to provide informed consent

Exclusion Criteria

* Being pregnant at study enrollment
* Planning on leaving the community where they currently reside in the next 12 months
* Enrolled in HIV care in the past 6 months at any clinic
* Initiated ART (for any duration) in the past 6 months at any clinic
* Currently on ART
* Does not speak or understand Portuguese or Xitswa/Matswa
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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United States Agency for International Development (USAID)

FED

Sponsor Role collaborator

Columbia University

OTHER

Sponsor Role lead

Responsible Party

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Batya Elul

Assistant Professor of Epidemiology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Batya Elul, PhD, MSc

Role: PRINCIPAL_INVESTIGATOR

Columbia University

Locations

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Chicuque Health Center

Inhambane, , Mozambique

Site Status

Massinga Health Center

Inhambane, , Mozambique

Site Status

Maxixe Health Center

Inhambane, , Mozambique

Site Status

Morrumbene Health Center

Inhambane, , Mozambique

Site Status

Urbano Health Center

Inhambane, , Mozambique

Site Status

Zavala Health Center and Inharrime Health Center

Inhambane, , Mozambique

Site Status

Bagamoio Health Center

Maputo, , Mozambique

Site Status

Jose Macamo Health Center

Maputo, , Mozambique

Site Status

Mavalane General Hospital

Maputo, , Mozambique

Site Status

Zimpeto Health Center

Maputo, , Mozambique

Site Status

Countries

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Mozambique

References

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Elul B, Lamb MR, Lahuerta M, Abacassamo F, Ahoua L, Kujawski SA, Tomo M, Jani I. A combination intervention strategy to improve linkage to and retention in HIV care following diagnosis in Mozambique: A cluster-randomized study. PLoS Med. 2017 Nov 14;14(11):e1002433. doi: 10.1371/journal.pmed.1002433. eCollection 2017 Nov.

Reference Type DERIVED
PMID: 29136001 (View on PubMed)

Sutton R, Lahuerta M, Abacassamo F, Ahoua L, Tomo M, Lamb MR, Elul B. Feasibility and Acceptability of Health Communication Interventions Within a Combination Intervention Strategy for Improving Linkage and Retention in HIV Care in Mozambique. J Acquir Immune Defic Syndr. 2017 Jan 1;74 Suppl 1(Suppl 1):S29-S36. doi: 10.1097/QAI.0000000000001208.

Reference Type DERIVED
PMID: 27930609 (View on PubMed)

Elul B, Lahuerta M, Abacassamo F, Lamb MR, Ahoua L, McNairy ML, Tomo M, Horowitz D, Sutton R, Mussa A, Gurr D, Jani I. A combination strategy for enhancing linkage to and retention in HIV care among adults newly diagnosed with HIV in Mozambique: study protocol for a site-randomized implementation science study. BMC Infect Dis. 2014 Oct 15;14:549. doi: 10.1186/s12879-014-0549-5.

Reference Type DERIVED
PMID: 25311998 (View on PubMed)

Other Identifiers

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USAID-OAA-A-12-00027

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

AAAL1354

Identifier Type: -

Identifier Source: org_study_id

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