Trial Outcomes & Findings for Reducing Time to Spaced-out Appointments for Newly-diagnosed People Living With HIV (NCT NCT04567693)

NCT ID: NCT04567693

Last Updated: 2023-10-25

Results Overview

Percentage of participants with suppressed viral load (less than 200 copies/ml)

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

93 participants

Primary outcome timeframe

Measured at 12 months after enrollment into ART care

Results posted on

2023-10-25

Participant Flow

Participant milestones

Participant milestones
Measure
Early 1
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
Do not advance to spaced-out appointments during study period
Overall Study
STARTED
32
31
30
Overall Study
COMPLETED
30
31
24
Overall Study
NOT COMPLETED
2
0
6

Reasons for withdrawal

Reasons for withdrawal
Measure
Early 1
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
Do not advance to spaced-out appointments during study period
Overall Study
Death
0
0
2
Overall Study
Lost to Follow-up
1
0
2
Overall Study
Withdrawal by investigative team (participants did not meet eligibility criteria)
1
0
2

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Early 1
n=31 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=28 Participants
Do not advance to spaced-out appointments during study period
Total
n=90 Participants
Total of all reporting groups
Age, Continuous
30 years
STANDARD_DEVIATION 10 • n=31 Participants
33 years
STANDARD_DEVIATION 13 • n=31 Participants
29 years
STANDARD_DEVIATION 6 • n=28 Participants
31 years
STANDARD_DEVIATION 10 • n=90 Participants
Sex: Female, Male
Female
20 Participants
n=31 Participants
20 Participants
n=31 Participants
20 Participants
n=28 Participants
60 Participants
n=90 Participants
Sex: Female, Male
Male
11 Participants
n=31 Participants
11 Participants
n=31 Participants
8 Participants
n=28 Participants
30 Participants
n=90 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Region of Enrollment
Rwanda
31 participants
n=31 Participants
31 participants
n=31 Participants
28 participants
n=28 Participants
90 participants
n=90 Participants
ART Adherence
0.1 Days of ART missed in last 30 days
STANDARD_DEVIATION 0.72 • n=31 Participants
0.03 Days of ART missed in last 30 days
STANDARD_DEVIATION 0.18 • n=31 Participants
0.04 Days of ART missed in last 30 days
STANDARD_DEVIATION 0.19 • n=28 Participants
0.06 Days of ART missed in last 30 days
STANDARD_DEVIATION 0.44 • n=90 Participants
Satisfaction with care
Non-clinical
4.15 units on a scale
STANDARD_DEVIATION 0.34 • n=31 Participants
4.12 units on a scale
STANDARD_DEVIATION 0.34 • n=31 Participants
4.11 units on a scale
STANDARD_DEVIATION 0.49 • n=28 Participants
4.13 units on a scale
STANDARD_DEVIATION 0.40 • n=90 Participants
Satisfaction with care
Clinical
3.81 units on a scale
STANDARD_DEVIATION 0.28 • n=31 Participants
3.84 units on a scale
STANDARD_DEVIATION 0.21 • n=31 Participants
3.85 units on a scale
STANDARD_DEVIATION 0.24 • n=28 Participants
3.83 units on a scale
STANDARD_DEVIATION 0.24 • n=90 Participants
Enacted and Internalized Stigma
Enacted
1.04 units on a scale
STANDARD_DEVIATION 0.20 • n=31 Participants
1.03 units on a scale
STANDARD_DEVIATION 0.09 • n=31 Participants
1.00 units on a scale
STANDARD_DEVIATION 0.01 • n=28 Participants
1.00 units on a scale
STANDARD_DEVIATION 0.11 • n=90 Participants
Enacted and Internalized Stigma
Internalized
2.02 units on a scale
STANDARD_DEVIATION 0.77 • n=31 Participants
1.62 units on a scale
STANDARD_DEVIATION 0.72 • n=31 Participants
2.08 units on a scale
STANDARD_DEVIATION 0.97 • n=28 Participants
1.90 units on a scale
STANDARD_DEVIATION 0.80 • n=90 Participants
Quality of life
45.0 units on a scale
STANDARD_DEVIATION 14.0 • n=31 Participants
45.5 units on a scale
STANDARD_DEVIATION 17.7 • n=31 Participants
37.9 units on a scale
STANDARD_DEVIATION 16.2 • n=28 Participants
42.9 units on a scale
STANDARD_DEVIATION 16.2 • n=90 Participants
Anticipated stigma
2.40 units on a scale
STANDARD_DEVIATION .074 • n=31 Participants
2.40 units on a scale
STANDARD_DEVIATION 0.72 • n=31 Participants
2.43 units on a scale
STANDARD_DEVIATION 0.85 • n=28 Participants
2.40 units on a scale
STANDARD_DEVIATION 0.70 • n=90 Participants

PRIMARY outcome

Timeframe: Measured at 12 months after enrollment into ART care

Population: Note: as the primary, intention to treat outcome, persons who did not complete the study were treated as being not virally suppressed. 3 enrolled participants were assigned to groups (one participant to the 'Early 1' group and two participants to the 'Usual Care' group), but subsequently withdrawn from the study when it became clear that they did not meet eligibility criteria. Their data were not included in the analyses.

Percentage of participants with suppressed viral load (less than 200 copies/ml)

Outcome measures

Outcome measures
Measure
Early 1
n=31 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=28 Participants
Do not advance to spaced-out appointments during study period
Viral Suppression
25 Participants
25 Participants
19 Participants

SECONDARY outcome

Timeframe: Measured at 12 months after enrollment into ART care

Population: Appointment adherence was defined in the protocol as the proportion of participants in each arm who attended all scheduled clinical appointments and ART pick-ups during the study. We planned to ascertain appointment adherence through review of participants' medical files at the conclusion of the study. During medical file review, it became apparent that scheduled appointments (i.e. next planned) were inconsistently documented. We therefore were unable to accurately ascertain this outcome.

Proportion of participants that attended all pharmacy and clinical appointments

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Measured at 12 months after enrollment into ART care

The Satisfaction With Care scale is a 9-item scale containing questions about satisfaction with clinical (n=6) and non-clinical elements (n=3) of health care. Participants describe satisfaction with each element on a 5-point Likert scale (very unsatisfied \[1\], not satisfied \[2\], no opinion \[3\], satisfied \[4\], very satisfied \[5\]). Satisfaction with clinical and non-clinical care elements are reported separately, by summing scores (1-5) for each item and then dividing by the number of items within each subscale. Subscale scores range from 1 to 5; higher scores indicate greater satisfaction.

Outcome measures

Outcome measures
Measure
Early 1
n=30 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=24 Participants
Do not advance to spaced-out appointments during study period
Participant Acceptability of Reduced Time to Spaced-out Appointments
Non-clinical
4.2 score on a scale (Likert)
Standard Deviation 0.5
4.3 score on a scale (Likert)
Standard Deviation 0.5
4.2 score on a scale (Likert)
Standard Deviation 0.6
Participant Acceptability of Reduced Time to Spaced-out Appointments
Clinical aspects of care
3.9 score on a scale (Likert)
Standard Deviation 0.3
4.0 score on a scale (Likert)
Standard Deviation 0.3
3.9 score on a scale (Likert)
Standard Deviation 0.3

SECONDARY outcome

Timeframe: Measured at 12 months after enrollment into ART care

Population: Overriding of study assignment was only examined for participants in intervention arms (Early 1 and Early 2). 3 enrolled participants were assigned to groups (one participant to the 'Early 1' group and two participants to the 'Usual Care' group), but subsequently withdrawn from the study when it became clear that they did not meet eligibility criteria. As such, data for one 'Early 1' group participant was not included in the analyses.

Acceptability of reduced time to spaced-out appointments, as measured by the number of instances when providers overrode the study assignment. Override could only occur a maximum of one time for each participant.

Outcome measures

Outcome measures
Measure
Early 1
n=31 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
Do not advance to spaced-out appointments during study period
Provider Acceptability of Reduced Time to Spaced-out Appointments
7 Participants
6 Participants
0 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Measured at 6 months after enrollment in ART care

As measured by the HIV/AIDS Stigma Instrument-PLWA (HASI-P) Scale. The HASI-P is a 33-item scale that contains questions in 6 different stigma-related domains or factors. For each item, participants are asked to describe the frequency of experienced stigmatizing events in the past 3 months on a 4-point Likert scale (0- Never, 1- Once or twice, 2- Several times, or 3- Most of the time), with higher scores indicating greater stigma. The instrument is scored by summing the scores (0-3) for each item and then dividing by the number of items within each factor (enacted or internalized stigma).

Outcome measures

Outcome measures
Measure
Early 1
n=30 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=24 Participants
Do not advance to spaced-out appointments during study period
Enacted and Internalized Stigmas
Enacted stigma
1.00 score on a scale
Standard Deviation 0.01
1.00 score on a scale
Standard Deviation 0.00
1.02 score on a scale
Standard Deviation 0.10
Enacted and Internalized Stigmas
Internalized stigma
1.35 score on a scale
Standard Deviation 0.66
1.39 score on a scale
Standard Deviation 0.80
1.27 score on a scale
Standard Deviation 0.54

OTHER_PRE_SPECIFIED outcome

Timeframe: 12-months

Repeated measures analysis of participant direct and indirect costs. While we initially planned to report measurements at 1-, 6- and 12-months after enrollment in ART care, we ultimately reported direct and indirect average costs at 12 months by adding the reported costs at each of the 3 time points to calculate the cost over the entire study period, and then dividing by the number of visits to the health center.

Outcome measures

Outcome measures
Measure
Early 1
n=30 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=24 Participants
Do not advance to spaced-out appointments during study period
Participant Health-related Costs
4562 Rwandan Francs (currency)
Standard Deviation 4034
4817 Rwandan Francs (currency)
Standard Deviation 3716
4842 Rwandan Francs (currency)
Standard Deviation 3948

OTHER_PRE_SPECIFIED outcome

Timeframe: Measured at 12-months after enrollment in ART care

Repeated measures analysis of patient self-reported ART adherence

Outcome measures

Outcome measures
Measure
Early 1
n=30 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=24 Participants
Do not advance to spaced-out appointments during study period
ART Adherence
0.8 Days of ART missed in last 30 days
Standard Deviation 1.2
1.1 Days of ART missed in last 30 days
Standard Deviation 5.4
0.6 Days of ART missed in last 30 days
Standard Deviation 1.1

OTHER_PRE_SPECIFIED outcome

Timeframe: Measured at 6 months after enrollment in ART care

Repeated measures analysis of patient self-reported ART adherence

Outcome measures

Outcome measures
Measure
Early 1
n=30 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=24 Participants
Do not advance to spaced-out appointments during study period
ART Adherence
0.9 Days of ART missed in last 30 days
Standard Deviation 2.0
1.6 Days of ART missed in last 30 days
Standard Deviation 5.5
0.6 Days of ART missed in last 30 days
Standard Deviation 1.1

OTHER_PRE_SPECIFIED outcome

Timeframe: Measured at 6 months after enrollment in ART care

Repeated measures analysis of participant quality of life as measured by the EuroQOL-5 Dimension-5 Levels (EQ-5D-5L) Visual Analog Scale (VAS). The EQ-5D-5L is a 5-level scale that measures self-rated problems (no problems, slight problems, moderate problems, severe problems and extreme problems) in 5 domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) as well as self-rated health. For this measure, we chose to use only the VAS, which asks respondents to rate their overall health from 0-100, with higher scores indicating greater self-rated health.

Outcome measures

Outcome measures
Measure
Early 1
n=30 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=24 Participants
Do not advance to spaced-out appointments during study period
Perceived Quality of Life
52.2 score on a scale
Standard Deviation 11.5
53.6 score on a scale
Standard Deviation 13.8
50.4 score on a scale
Standard Deviation 14.6

OTHER_PRE_SPECIFIED outcome

Timeframe: Measured at 12 months after enrollment in ART care

Repeated measures analysis of participant quality of life as measured by the EuroQOL-5 Dimension-5 Levels (EQ-5D-5L) Visual Analog Scale (VAS). The EQ-5D-5L is a 5-level scale that measures self-rated problems (no problems, slight problems, moderate problems, severe problems and extreme problems) in 5 domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) as well as self-rated health. For this measure, we chose to use only the VAS, which asks respondents to rate their overall health from 0-100, with higher scores indicating greater self-rated health.

Outcome measures

Outcome measures
Measure
Early 1
n=30 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=24 Participants
Do not advance to spaced-out appointments during study period
Perceived Quality of Life
52.2 score on a scale
Standard Deviation 10.3
54.5 score on a scale
Standard Deviation 11.4
54.4 score on a scale
Standard Deviation 10.1

OTHER_PRE_SPECIFIED outcome

Timeframe: Measured at 6 months after enrollment in ART care

The Satisfaction With Care scale is a 9-item scale containing questions about satisfaction with clinical (n=6) and non-clinical elements (n=3) of health care. Participants describe satisfaction with each element on a 5-point Likert scale (very unsatisfied \[1\], not satisfied \[2\], no opinion \[3\], satisfied \[4\], very satisfied \[5\]). Satisfaction with clinical and non-clinical care elements are reported separately, by summing scores (1-5) for each item and then dividing by the number of items within each subscale. Subscale scores range from 1 to 5; higher scores indicate greater satisfaction.

Outcome measures

Outcome measures
Measure
Early 1
n=30 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=24 Participants
Do not advance to spaced-out appointments during study period
Satisfaction With Care
Non-clinical
3.96 score on a scale
Standard Deviation 0.46
3.98 score on a scale
Standard Deviation 0.26
4.04 score on a scale
Standard Deviation 0.33
Satisfaction With Care
Clinical
3.74 score on a scale
Standard Deviation 0.18
3.72 score on a scale
Standard Deviation 0.19
3.72 score on a scale
Standard Deviation 0.21

OTHER_PRE_SPECIFIED outcome

Timeframe: Measured at 6 months after enrollment in ART care

As measured by an adapted version of the HIV stigma scale (anticipated stigma). Anticipated stigma is rated on a 5-point Likert-type scale (Very Unlikely \[1\] to Very Likely \[5\]), with higher scores indicating greater stigma. Items are averaged to create a composite score.

Outcome measures

Outcome measures
Measure
Early 1
n=30 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=24 Participants
Do not advance to spaced-out appointments during study period
Anticipated Stigma
2.43 score on a scale
Standard Deviation 0.57
2.37 score on a scale
Standard Deviation 0.59
2.73 score on a scale
Standard Deviation 0.66

OTHER_PRE_SPECIFIED outcome

Timeframe: Measured at 12 months after enrollment in ART care

As measured by an adapted version of the HIV stigma scale (anticipated stigma). Anticipated stigma is rated on a 5-point Likert-type scale (Very Unlikely \[1\] to Very Likely \[5\]), with higher scores indicating greater stigma. Items are averaged to create a composite score.

Outcome measures

Outcome measures
Measure
Early 1
n=30 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=24 Participants
Do not advance to spaced-out appointments during study period
Anticipated Stigma
2.41 score on a scale
Standard Deviation 0.77
2.37 score on a scale
Standard Deviation 0.52
2.45 score on a scale
Standard Deviation 0.56

OTHER_PRE_SPECIFIED outcome

Timeframe: Measured at 12 months after enrollment in ART care

As measured by the HIV/AIDS Stigma Instrument-PLWA (HASI-P) Scale. The HASI-P is a 33-item scale that contains questions in 6 different stigma-related domains or factors. For each item, participants are asked to describe the frequency of experienced stigmatizing events in the past 3 months on a 4-point Likert scale (0- Never, 1- Once or twice, 2- Several times, or 3- Most of the time), with higher scores indicating greater stigma. The instrument is scored by summing the scores (0-3) for each item and then dividing by the number of items within each factor (enacted or internalized stigma).

Outcome measures

Outcome measures
Measure
Early 1
n=30 Participants
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 5-month viral load are suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 Participants
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In this arm, starting at 6 months after ART initiation, participants whose 3- and 5-month viral loads are both suppressed attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=24 Participants
Do not advance to spaced-out appointments during study period
Enacted and Internalized Stigmas
Enacted stigma
1.00 score on a scale
Standard Deviation 0.00
1.04 score on a scale
Standard Deviation 0.20
1.05 score on a scale
Standard Deviation .018
Enacted and Internalized Stigmas
Internalized stigma
1.11 score on a scale
Standard Deviation 0.40
1.21 score on a scale
Standard Deviation 0.58
1.10 score on a scale
Standard Deviation 0.27

Adverse Events

Early 1

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Early 2

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Usual Care

Serious events: 0 serious events
Other events: 2 other events
Deaths: 2 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Early 1
n=31 participants at risk
Advance to spaced-out appointments at month 6 after a single viral load is measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In the intervention arms, participants will attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Early 2
n=31 participants at risk
Advance to spaced-out appointments at month 6 after two viral loads are measured. Early spaced-out appointments: Newly-diagnosed PLWH currently attend health centers monthly for ART pick-up and quarterly for clinical visits. In the intervention arms, participants will attend health centers quarterly for ART pick-up and semi-annually for clinical visits.
Usual Care
n=28 participants at risk
Do not advance to spaced-out appointments during study period
Pregnancy, puerperium and perinatal conditions
Became pregnant during study
6.5%
2/31 • Number of events 2 • Adverse event data were collected on participants during their participation in the study (12 months)
3.2%
1/31 • Number of events 1 • Adverse event data were collected on participants during their participation in the study (12 months)
3.6%
1/28 • Number of events 1 • Adverse event data were collected on participants during their participation in the study (12 months)
Social circumstances
Incarcerated during study
0.00%
0/31 • Adverse event data were collected on participants during their participation in the study (12 months)
0.00%
0/31 • Adverse event data were collected on participants during their participation in the study (12 months)
3.6%
1/28 • Number of events 1 • Adverse event data were collected on participants during their participation in the study (12 months)
Infections and infestations
Developed tuberculosis during study
3.2%
1/31 • Number of events 1 • Adverse event data were collected on participants during their participation in the study (12 months)
0.00%
0/31 • Adverse event data were collected on participants during their participation in the study (12 months)
0.00%
0/28 • Adverse event data were collected on participants during their participation in the study (12 months)

Additional Information

Dr. Jonathan Ross

Montefiore Medical Center

Phone: 718-920-7064

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place