Community-based Interventions to Increase HIV Testing and HIV Care Utilization

NCT01867177 | Completed DMC

• 1 other identifier: KP2012
• Study Type: interventional
• Target: 583
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to conduct a cross-site evaluation of the Kaiser Permanente's Community-based Interventions to Increase HIV Testing and HIV Care Utilization Program, designed to support community-based interventions to reduce the number of new HIV cases and to increase HIV care acquisition and maintenance in minority communities disproportionately affected by the HIV epidemic. This effort builds on the President's National Strategy for HIV Prevention and recent research documenting the importance and efficacy of "test and treat" and "treatment as prevention" approaches. Hence, goals of this important and novel work will focus on the following objectives:

1. 1.identification of HIV infection among recently infected adolescents and adults
2. 2.improved access to HIV care, particularly among newly diagnosed adolescents and adults
3. 3.increased HIV testing among populations at risk for HIV
4. 4.improved health care utilization among HIV infected adults and adolescents

Conditions

HIV

Keywords

HIV; health care utilization; HIV testing; access to care

Outcome Measures

Primary Outcomes (1)

• Increased HIV care utilization

  Improved access to HIV care, particularly among newly diagnosed adults.

  3 and 6 months following intervention

Secondary Outcomes (1)

• Increased HIV testing among populations at risk for HIV

  at baseline

Study Arms (3)

HIV testing

OTHER

Identification of HIV infection among recently infected adults

Other: HIV testing

HIV care utilization

EXPERIMENTAL

Improved access to HIV care and HIV care utilization, particularly among newly diagnosed adults

Behavioral: HIV care utilization

standard of care

ACTIVE COMPARATOR

Standard of HIV care; standard of linkage to HIV care

Other: standard of HIV care

Interventions

HIV testing OTHER

HIV testing. Enhanced testing protocol is used: RESPECT, an evidence-based HIV prevention counseling intervention helping people increase condom use, decrease risky behaviors (resulting in a decrease in STIs) compared to those who did not receive the intervention. RESPECT includes: one-on-one counseling using a structured protocol; "teachable moments" during counseling to motivate clients to change risk-taking behaviors; to explore the contexts in which risk behaviors occur to increase awareness of susceptibility; and negotiate achievable "next steps" with the client that support the larger risk reduction goal. Implemented using a structured protocol with monitoring to ensure the fidelity of the testing intervention.

HIV testing

standard of HIV care OTHER

Standard linkage and referral to HIV care includes HIV counseling, testing, and referrals. Both intervention and comparison groups will receive these.

standard of care

HIV care utilization BEHAVIORAL

Sites will use a peer-based, client navigation model of an Integrated HIV/AIDS Early Intervention Services (ARTAS), Community Health Worker (CHW) Program, case management/support services linking people to continuous, coordinated care after HIV dx. Another site will do Motivational Enhancement Intervention (MEI) sessions with quality of ife workshops and support groups. Health Educators recruit clients, make appointments, escort to test sites, intake, review. Additional components can include food security support, social and group support, drop in centers, text messaging and social media, depending on sites. All sites focus on approaches to reach community members and facilitate their supportive linkage to care with behavioral and structural supports.

HIV care utilization

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Individuals will be adults,
• aged 18 and over,
• with the capacity to give informed consent.

You may not qualify if:

• Those who do not have the capacity to give informed consent will be excluded.

Sponsors & Collaborators

• Kaiser Permanente: lead
• University of California, San Diego: collaborator

Study Sites (1)

University of California, San Diego, School of Medicine, Division of Global Public Health

La Jolla, California, 92093, United States

Location

Related Publications (4)

• CDC, HIV/AIDS Surveillance Report. 2007; 19:7. Available at http://www.cdc.gov/hiv/topics/surveillance/resources/reports/2007report/pdf/2007SurveillanceRpoert.pdf

  BACKGROUND

• Losina E, Schackman BR, Sadownik SN, Gebo KA, Walensky RP, Chiosi JJ, Weinstein MC, Hicks PL, Aaronson WH, Moore RD, Paltiel AD, Freedberg KA. Racial and sex disparities in life expectancy losses among HIV-infected persons in the united states: impact of risk behavior, late initiation, and early discontinuation of antiretroviral therapy. Clin Infect Dis. 2009 Nov 15;49(10):1570-8. doi: 10.1086/644772.

  PMID: 19845472 BACKGROUND

• Ojikutu B, Johns Hopkins Advanced Studies in Medicine, Overcoming Challenges To Accessing and Adhering to Care in Minority Patients Living with HIV, 2010;2:37-41

  BACKGROUND

• HIV Prevention Trials Network. Available at http://www.hptn.org/web%20documents/PressReleases/HPTN052PressReleaseFINAL5_12_118am.pdf.

  BACKGROUND

MeSH Terms

Conditions

Patient Acceptance of Health Care

Interventions

HIV Testing

Condition Hierarchy (Ancestors)

Treatment Adherence and Compliance; Health Behavior; Behavior

Intervention Hierarchy (Ancestors)

Microbiological Techniques; Clinical Laboratory Techniques; Diagnostic Techniques and Procedures; Diagnosis; Investigative Techniques

Study Officials

• Anita Raj, PhD

  University of California, San Diego

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 29, 2013
• First Posted: June 3, 2013
• Study Start: June 1, 2013
• Primary Completion: December 1, 2016
• Study Completion: December 1, 2017
• Last Updated: July 31, 2018

Record last verified: 2018-07

Locations

US (1)