NCT02310893

Brief Summary

Consistent treatment with anti-retroviral therapy (ART) suppresses viral load (VL), prolonging life and improving quality of life for HIV+ persons. Suppressing VL benefits communities by reducing transmission to others. Mere availability of ART and care, however, is insufficient; the benefits of ART depend upon HIV+ persons' continuous visits to the health care provider, regular monitoring and regular delivery of medications, - known as retention in HIV care. In spite of national efforts, up to a quarter of HIV+ persons, especially low-income minorities are out of care. Innovative interventions are therefore urgently needed to maximize engagement and retention in HIV care, self-reported adherence, as well as HIV-1 RNA viral load suppression. In pursuit of these aims, the proposed study will assess outcomes of the following interventions in comparison to usual care: 1) contingency management (CM) only; 2) peer navigation (PN) only; and 3) a combined approach that integrates both CM and PN (CA) which the investigators hypothesize to be most effective in improving HIV clinical outcomes.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
579

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jan 2016

Longer than P75 for not_applicable

Geographic Reach
1 country

6 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

July 18, 2014

Completed
5 months until next milestone

First Posted

Study publicly available on registry

December 8, 2014

Completed
1.1 years until next milestone

Study Start

First participant enrolled

January 1, 2016

Completed
3.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2019

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

January 1, 2020

Completed
Last Updated

November 17, 2020

Status Verified

November 1, 2020

Enrollment Period

3.9 years

First QC Date

July 18, 2014

Last Update Submit

November 16, 2020

Conditions

Outcome Measures

Primary Outcomes (2)

  • Change in retention-in-care behaviors over 12 months

    Using a 2x2 factorial design, to examine the effect of the three interventions -- peer navigation, contingency management, combined approach and usual care -- and evaluate how well they improve retention in HIV care

    Basline, follow-ups at month 2, 6, 12

  • Change in HIV RNA viral load suppression and medication adherence over 12 months

    Using the same design, to examine the effects of the PN, CM and, CA interventions on HIV RNA viral load suppression and self-reported adherence

    Basline, follow-ups at month 2, and 12

Secondary Outcomes (1)

  • Cost effectiveness

    5 years

Study Arms (4)

Contingency Management only

ACTIVE COMPARATOR

Participants assigned to this arm will receive payments for attending regular HIV medical appointments at the clinic and filling prescribed HIV medications at the pharmacy

Behavioral: Contingency Management

Peer Navigation only

ACTIVE COMPARATOR

Participants in this arm will be assigned a peer navigator to assist them in accessing and remaining in HIV care

Behavioral: Peer Navigation

Combined Contingency Management and Peer Navigation

EXPERIMENTAL

Participants in this arm will be assigned a peer navigator to assist them in accessing and remaining in HIV care and will be eligible to receive incentives for attending HIV care visits/refilling prescriptions.

Behavioral: Combined Contingency Management and Peer Navigation

Usual care

NO INTERVENTION

Participants in this arm will receive the care that they would usually get in their clinic in the absence of this study.

Interventions

Combined Contingency Management and Peer Navigation
Contingency Management only
Peer NavigationBEHAVIORAL
Peer Navigation only

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Diagnosed HIV+
  • Age 18 years or older
  • English or Spanish speaking
  • Residence in Los Angeles County
  • prescribed ART in prior 24 months
  • \< 3 visits in prior 12 months or have detectable viral load, as identified in the Ryan White CaseWatch database

You may not qualify if:

  • Not meeting any of the criteria identified above

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (6)

Center for Health Justice

Los Angeles, California, 90012, United States

Location

Los Angeles Sheriff's Department

Los Angeles, California, 90012, United States

Location

AltaMed Health Services Corporation

Los Angeles, California, 90022, United States

Location

Oasis Clinic

Los Angeles, California, 90059, United States

Location

Olive View Medical Center

Sylmar, California, 91342, United States

Location

Northeast Valley Health Corporation

Van Nuys, California, 91401, United States

Location

MeSH Terms

Conditions

Acquired Immunodeficiency Syndrome

Condition Hierarchy (Ancestors)

HIV InfectionsBlood-Borne InfectionsCommunicable DiseasesInfectionsSexually Transmitted Diseases, ViralSexually Transmitted DiseasesLentivirus InfectionsRetroviridae InfectionsRNA Virus InfectionsVirus DiseasesSlow Virus DiseasesGenital DiseasesUrogenital DiseasesImmunologic Deficiency SyndromesImmune System Diseases

Study Officials

  • William Cunningham, MD, MPH

    University of California, Los Angeles

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 18, 2014

First Posted

December 8, 2014

Study Start

January 1, 2016

Primary Completion

December 1, 2019

Study Completion

January 1, 2020

Last Updated

November 17, 2020

Record last verified: 2020-11

Locations