Optimizing HIV Virologic Outcomes for Pregnant Women in Uganda

NCT ID: NCT04122144

Last Updated: 2019-10-17

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

980 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-09-19

Study Completion Date

2022-09-19

Brief Summary

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The ENHANCED -SPS study is a before and after cluster randomized trial that will be conducted in 14 public health facilities providing HIV care in Southwestern Uganda. The study will evaluate the effectiveness of a multi-component intervention package that targets barriers to achieving optimal viral suppression among pregnant and postpartum women infected with HIV. This will be in two phases; In Phase 1 ("Before"), all 14 clinics will have a baseline assessment of standard of care VL procedures and assess the barriers and facilitators to viral suppression for a period of 3 months. In Phase 2 ("After"), 7 clinics randomized to control arm will continue to experience standard of care counseling procedures, and 7 clinics randomized to intervention will initiate the ENHANCE-PS intervention. The Phase 2 ("After") phase I will last at least 12 months.

Detailed Description

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The Investigators will test the hypothesis that the Enhanced viral load (VL) counseling and standardized peer mother support (ENHANCED-SPS) intervention will increase viral load suppression among HIV-infected pregnant and post-partum women and increase retention of mothers in care hence resulting in reduced risk of vertical transmission in south western Uganda.

Specific objectives are as follows:

1\) To evaluate the effectiveness of an enhanced VL counseling and standardized peer mother support intervention on viral suppression among HIV infected pregnant women at 12 months of follow up; 2) To evaluate the effect of the enhanced counseling and peer support intervention on retention in care at 18 months postpartum follow up; The investigators will randomize 14 HIV clinics to the ENHANCED-SPS multi-component intervention vs. standard of care procedures (intervention=7 clinics and control=7 clinics,n=70 mothers/health facility) ;3) To assess the facilitators and barriers of VL and enhanced VL counseling and peer mother support intervention at 9 \& 18 months of follow up.This will consider both patient and providers perspectives of the intervention implementation

Conditions

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HIV

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Comparative effectiveness cluster-randomized trial
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Intervention

ENHANCED-SPS intervention implemented

Group Type EXPERIMENTAL

ENHANCED -SPS intervention

Intervention Type BEHAVIORAL

a) Enhanced VL counseling: Explanation of VL \& Importance of VL suppression,assessment of adherence, counseling based on VL result and schedule for next VL testing and the role of VL and the MTCT risk; b).Standardized peer mother support: includes training of peer mothers on mandatory enhanced VL counseling during the routine peer counseling and education, follow up of mothers and continued adherence counseling and disclosure support and bi-weekly phone calls to mothers to provide VL counseling and follow up

Control

Standard of care maintained. These are procedures conducted during the routine HIV care visits at the health facilities include ART card documentation as required, general/routine counseling, and adherence counseling to the non suppressors, ART drug supply based on the clinicians prescription and laboratory monitoring.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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ENHANCED -SPS intervention

a) Enhanced VL counseling: Explanation of VL \& Importance of VL suppression,assessment of adherence, counseling based on VL result and schedule for next VL testing and the role of VL and the MTCT risk; b).Standardized peer mother support: includes training of peer mothers on mandatory enhanced VL counseling during the routine peer counseling and education, follow up of mothers and continued adherence counseling and disclosure support and bi-weekly phone calls to mothers to provide VL counseling and follow up

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

1. All Pregnant women and breastfeeding mothers enrolled in the mother baby care points/HIV clinics with documented HIV infection
2. . HIV infected Pregnant women reporting for their first ANC within the study clinics or newly identified HIV positive mothers from the ANC clinics/breastfeeding

Exclusion Criteria

3. . All women who will be critically ill and unable to communicate
4. . Those not willing to consent to participate in the study
5. . Women who will not be able to understand all information concerning the study
Minimum Eligible Age

15 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Infectious Diseases Research Collaboration, Uganda

OTHER

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role collaborator

Makerere University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jane Kabami, MPH

Role: PRINCIPAL_INVESTIGATOR

Makerere University

Moses Kamya, PhD

Role: PRINCIPAL_INVESTIGATOR

Makerere University

Phillipa Musoke, PhD

Role: PRINCIPAL_INVESTIGATOR

Makerere University

Locations

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Jane Kabami

Kampala, Mbarara, Uganda

Site Status RECRUITING

Countries

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Uganda

Central Contacts

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Jane Kabami, MPH

Role: CONTACT

+256776411044

Moses Kamya, PhD

Role: CONTACT

+256752900012

Facility Contacts

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Jane Kabami

Role: primary

0776411044

Elizabeth Arinitwe, BNSc

Role: backup

+256752900542

Other Identifiers

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HS 2648

Identifier Type: OTHER

Identifier Source: secondary_id

REC REF 2018-074

Identifier Type: -

Identifier Source: org_study_id

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