Counseling and Reminders for Regular HIV and STIs Screening

NCT ID: NCT02752152

Last Updated: 2021-02-16

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

1961 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-12-09

Study Completion Date

2020-10-18

Brief Summary

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Counseling intervention:

Primary objective: to evaluate and compare, in at-risk populations, the efficacy of three different counseling methods in terms of propensity to come back for a HIV re-test. Secondary objectives: to evaluate and compare the efficacy of the counseling methods in terms of reported risk behavior and HIV knowledge as well as their acceptability and cost-effectiveness; describe the distribution of duration from HIV primary infection to detection; and estimate the prevalence of chronic hepatitis B and C, and syphilis in HIV-uninfected participants of targeted populations.

Reminder intervention Primary objective: to evaluate and compare, in at-risk individuals who require frequent testing, the efficacy of reminders in terms of propensity to come back for a HIV re-test within 7 months.

Secondary objective: to assess the cost-effectiveness of reminders.

The interim analyses have shown that that some strategies are better than the others and the Advisory Committee recommended to use only the most efficient strategies (Computer assisted counseling and Scheduling an appointment and sending reminder to clients).

In addition, CD4 cell count normal ranges in 30 HIV uninfected individuals in Thailand will be assessed. Transient elastometry (FibroScan) will be used to assess liver fibrosis in participants with and without viral hepatitis.

Detailed Description

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The study will be presented to clients, who will be asked to formally consent to participate. Clients residing or working in Thailand and able to communicate with the counselor will be eligible. Foreigners staying in Thailand for vacation or retirement will be excluded, except if presenting together with their partner who is otherwise eligible for the study. At each visit, participants will be proposed an appointment for a re-test. If they wish, the study team will send them reminders.

At the first visit, participants will be randomly assigned to one of three different methods for counseling on HIV, hepatitis B and C, and syphilis: standard face-to-face counseling, computer-assisted informational/educational counseling, or on-demand counseling (the counselor invites the participant to ask questions). Participants will then be randomly assigned to one of three reminder strategies: Appointment+reminder, Reminder only, or No appointment and no reminder.

At each visit, blood sample will be collected to test for HIV, hepatitis B and C, and syphilis. Laboratory examinations will be free of charge for all participants. After the blood draw, participants will be invited to complete a questionnaire to assess their knowledge, attitudes and practices with regard to HIV and other infections. Test results will then be provided. In case of confirmed HIV infection, participants will be provided with further counseling, CD4 cell count measurement and referral options for immediate treatment. Blood samples collected during the study for the diagnosis will be stored for determination of the Fiebig stage (duration since HIV primary infection), evaluation of transmitted HIV drug resistance (sequencing) and investigation of viral transmission networks.

In a substudy, we will compare liver fibrosis assessed by transient elastometry and serum biomarkers (i.e. APRI and FIB-4) in Napneung participants with HBsAg and those with anti-HCV antibodies, and compare the measures with that obtained in participants negative for these tests.

The interim analyses have shown that that some strategies are better than the others and the Advisory Committee recommended to use only the most efficient strategies (Computer assisted counseling and Scheduling an appointment and sending reminder to clients). Thus the accrual to the arms "No appointment, no reminder" and "Reminder only" has been discontinued on 12 January 2019.

Following the published of CD4 cell count normal ranges in HIV uninfected individuals in Thailand since 1997 (Vithayasai, Sirisanthana, Sakonwasun, \& Suvanpiyasiri, 1997), It is unknown whether these norms have changed in relation to changes in nutritional status and lifestyle in young adults. We will assess the number of CD4 cells/mL in the blood of the first 30 HIV-uninfected female and the first 30 HIV-uninfected male clients aged less than 26 years to determine whether there is a trend for an increase in young people due to the changes in nutrition and lifestyle during the last decades. This sub-study will be conducted from 1 February 2019 to 31 January 2021.

Conditions

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HIV, Hepatitis B, Hepatitis C and Syphilis Infections

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Computer-assisted counseling

Computer-assisted informational/educational interactive session followed by an interactive face-to-face session to discuss personal issues with a counselor as needed

Group Type EXPERIMENTAL

Computer-assisted counseling

Intervention Type BEHAVIORAL

The counselor opens the computer-assisted information/educational interactive counseling program on the tablet computer and invites the participant to use the program.

Appointment + reminder

Intervention Type BEHAVIORAL

Has an appointment and receive reminders for further testing

Reminder

Intervention Type BEHAVIORAL

Only receive reminders for further testing

No appointment and no reminder

Intervention Type BEHAVIORAL

No appointment and no reminders for further testing

On-demand counseling

The counselor asks whether the participant has any questions

Group Type EXPERIMENTAL

On-demand counseling

Intervention Type BEHAVIORAL

The counselor only invites the participants to ask questions about HIV and other STIs.

Appointment + reminder

Intervention Type BEHAVIORAL

Has an appointment and receive reminders for further testing

Reminder

Intervention Type BEHAVIORAL

Only receive reminders for further testing

No appointment and no reminder

Intervention Type BEHAVIORAL

No appointment and no reminders for further testing

Standard counseling

Interactive face-to-face counseling session

Group Type ACTIVE_COMPARATOR

Standard counseling

Intervention Type BEHAVIORAL

The counselor gives face-to-face general information/education

Appointment + reminder

Intervention Type BEHAVIORAL

Has an appointment and receive reminders for further testing

Reminder

Intervention Type BEHAVIORAL

Only receive reminders for further testing

No appointment and no reminder

Intervention Type BEHAVIORAL

No appointment and no reminders for further testing

Appointment + reminder

Make appointment and send SMS reminder

Group Type EXPERIMENTAL

Computer-assisted counseling

Intervention Type BEHAVIORAL

The counselor opens the computer-assisted information/educational interactive counseling program on the tablet computer and invites the participant to use the program.

On-demand counseling

Intervention Type BEHAVIORAL

The counselor only invites the participants to ask questions about HIV and other STIs.

Standard counseling

Intervention Type BEHAVIORAL

The counselor gives face-to-face general information/education

Appointment + reminder

Intervention Type BEHAVIORAL

Has an appointment and receive reminders for further testing

Reminder only

Send SMS reminder only

Group Type EXPERIMENTAL

Computer-assisted counseling

Intervention Type BEHAVIORAL

The counselor opens the computer-assisted information/educational interactive counseling program on the tablet computer and invites the participant to use the program.

On-demand counseling

Intervention Type BEHAVIORAL

The counselor only invites the participants to ask questions about HIV and other STIs.

Standard counseling

Intervention Type BEHAVIORAL

The counselor gives face-to-face general information/education

Reminder

Intervention Type BEHAVIORAL

Only receive reminders for further testing

No appointment and no reminder

No appointment and no SMS reminder sent

Group Type ACTIVE_COMPARATOR

Computer-assisted counseling

Intervention Type BEHAVIORAL

The counselor opens the computer-assisted information/educational interactive counseling program on the tablet computer and invites the participant to use the program.

On-demand counseling

Intervention Type BEHAVIORAL

The counselor only invites the participants to ask questions about HIV and other STIs.

Standard counseling

Intervention Type BEHAVIORAL

The counselor gives face-to-face general information/education

No appointment and no reminder

Intervention Type BEHAVIORAL

No appointment and no reminders for further testing

Interventions

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Computer-assisted counseling

The counselor opens the computer-assisted information/educational interactive counseling program on the tablet computer and invites the participant to use the program.

Intervention Type BEHAVIORAL

On-demand counseling

The counselor only invites the participants to ask questions about HIV and other STIs.

Intervention Type BEHAVIORAL

Standard counseling

The counselor gives face-to-face general information/education

Intervention Type BEHAVIORAL

Appointment + reminder

Has an appointment and receive reminders for further testing

Intervention Type BEHAVIORAL

Reminder

Only receive reminders for further testing

Intervention Type BEHAVIORAL

No appointment and no reminder

No appointment and no reminders for further testing

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Residing or working in Thailand
* Able to communicate with the counselor
* Adults (\>= 18 years old)

Exclusion Criteria

* Foreigners staying in Thailand for vacation or retirement, except if they are presenting together with their partner staying permanently in Thailand or working in Thailand
* Couples requesting a couple counseling session
* HIV-positive participants (based on the client declaration)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Chiang Mai University

OTHER

Sponsor Role collaborator

Expertise France

OTHER

Sponsor Role collaborator

Institut de Recherche pour le Developpement

OTHER_GOV

Sponsor Role lead

Responsible Party

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GONZAGUE JOURDAIN

PHPT research Team

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gonzague Jourdain, MD. PhD

Role: PRINCIPAL_INVESTIGATOR

IRD

Locations

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Faculty of Associated Medical Sciences, Chiang Mai University

Chiang Mai, , Thailand

Site Status

MAP Foundation testing facility

Chiang Mai, , Thailand

Site Status

Special clinic of Chiangrai Prachanukroh Hospital

Chiang Rai, , Thailand

Site Status

Countries

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Thailand

References

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Salvadori N, Decker L, Ngo-Giang-Huong N, Mary JY, Chevret S, Arunothong S, Adam P, Khamduang W, Samleerat T, Luangsook P, Suksa-Ardphasu V, Achalapong J, Rouzioux C, Sirirungsi W, Jourdain G. Impact of Counseling Methods on HIV Retesting Uptake in At-Risk Individuals: A Randomized Controlled Study. AIDS Behav. 2020 May;24(5):1505-1516. doi: 10.1007/s10461-019-02695-2.

Reference Type DERIVED
PMID: 31605294 (View on PubMed)

Related Links

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https://www.napneung.org/

Official study site for the recruitment

https://th-th.facebook.com/napneung

Official facebook page for the recruitment

Other Identifiers

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Napneung-1

Identifier Type: -

Identifier Source: org_study_id

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