Community-based Delivery of Integrated Family Planning/HIV Testing and Counseling Services in Uganda

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

292 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-02-29

Study Completion Date

2013-06-30

Brief Summary

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The purpose of this study is to evaluate the feasibility and acceptability of adding HIV testing and counseling (HTC) services to the family planning (FP) services provided by community health workers in Uganda.

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Detailed Description

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The Uganda Ministry of Health is implementing a Village Health Team strategy whereby lay volunteers, called VHTs, provide a government-endorsed platform for all community-based health programming. Where trained, VHTs already offered family planning services, including injectable contraceptives. In this project, VHTs already providing family planning services are trained to offer HIV testing and counseling services (HTC). The goal is to reach individuals whose sexual and reproductive health needs may be underserved by clinic-based services, while also attempting to mitigate some of the barriers to HTC like access and stigma.

The study uses a two-arm post-test only randomized cluster design, with eight pair-matched health centers in two districts randomly assigned to intervention or control arm. VHTs supported by health centers in the intervention arm receive classroom training and supervised practical experience in HTC. Supervision and commodity supply occur through health centers, building on support mechanisms for family planning. External quality assurance is conducted quarterly through health centers as part of program implementation. VHTs receive refresher training after 8 months. VHTs in the intervention arm provide both family planning and HTC services during the study period, and then return to providing family planning only at the end of the project. VHTs in the control arm only provide family planning. HTC and/or family planning services, as applicable, are available to all adults in the communities served by the VHTs.

Conditions

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HIV Testing and Counseling

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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FP and HTC services

VHTs in the intervention arm provide both family planning and HTC services between May 2012 and September 2013, then return to providing family planning only at the end of the project. Services are made available to all adults in VHTs' communities. HIV testing is done using the national rapid testing algorithm. Clients who test positive for HIV are referred to a health center for care and treatment and receive disclosure support and information on peer support groups.

Group Type EXPERIMENTAL

FP and HTC services

Intervention Type OTHER

In this project, VHTs already providing family planning services are trained to offer HIV testing and counseling services (HTC).

FP services

VHTs in the control arm only provide family planning services.

Group Type ACTIVE_COMPARATOR

FP services

Intervention Type OTHER

VHTs in the control arm only provide family planning services

Interventions

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FP and HTC services

In this project, VHTs already providing family planning services are trained to offer HIV testing and counseling services (HTC).

Intervention Type OTHER

FP services

VHTs in the control arm only provide family planning services

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* At least six months of experience providing family planning services, including injectable contraceptives
* Attached to one of the eight health centers selected for the study for supervision, commodity supply, and referral management
* All VHTs in the intervention group are trained in HTC service provision and interviewed as part of the evaluation. VHTs in the control group are not interviewed.

* Age 18 or more
* Female
* Revisit family planning clients of VHTs (will have received family planning services from the VHT more than once)
* Where this service is available, having received HTC from the VHT is not an eligibility criterion