BRIDGE: Improving HIV Service Delivery for People Who Inject Drugs
2 other identifiers
interventional
616
2 countries
2
Brief Summary
Scaling up integrated, cost-efficient HIV services for people who inject drugs (PWID) in Needle Syringe Programs (NSPs) is urgently needed in Kazakhstan, where only one-third of the estimated 19,000 HIV-positive PWID are ever linked to HIV care and only 10% initiate ART with 4% achieving viral suppression. The study's aim is to evaluate the implementation, effectiveness, and sustainability of an integrated HIV service model in 24 NSPs located in 3 Kazakhstani city areas. This model will employ highly effective strategies that will include peer-driven recruitment of PWID in NSPs using social network strategies (SNS), integrating rapid HIV testing in NSPs with HIV Care Clinic nurses, and linking HIV positive PWID in NSPs to HIV care using the ARTAS (Anti-Retroviral Treatment and Access to Services) case management model. Findings will have important public health implications for improving HIV service delivery for PWID in the Central Asian region and other countries with injection driven epidemics.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Feb 2017
Longer than P75 for not_applicable
2 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
June 7, 2016
CompletedFirst Posted
Study publicly available on registry
June 10, 2016
CompletedStudy Start
First participant enrolled
February 1, 2017
CompletedPrimary Completion
Last participant's last visit for primary outcome
August 1, 2020
CompletedStudy Completion
Last participant's last visit for all outcomes
August 1, 2020
CompletedMay 31, 2022
July 1, 2021
3.5 years
June 7, 2016
May 26, 2022
Conditions
Keywords
Outcome Measures
Primary Outcomes (3)
Number of PWID who attend Needle Syringe Programs (NSPs) (Effectiveness Outcome)
NSP attendance from electronic case records
6 months
Number of PWID who receive an HIV test (Effectiveness Outcome)
HIV rapid testing
6 months
Number of HIV positive PWID who are referred to HIV care from NSPs (Effectiveness Outcome)
HIV care linkage from electronic case records
6 months
Secondary Outcomes (3)
Number of HIV positive NSP clients who register at HIV care clinic (Effectiveness Outcome)
6-months
Number of HIV positive NSP clients who have a viral load <1500 (Effectiveness Outcome)
6 months
Number of HIV positive NSP clients who initiate ART (Effectiveness Outcome)
6 months
Other Outcomes (2)
Incremental cost per participant who receives HIV-related medical services (Cost-Effectiveness Outcome)
6 months
Implementation outcomes
6 months
Study Arms (2)
Experimental: BRIDGE
EXPERIMENTALNSPs assigned to this arm would receive an integrated HIV service model
Pre-implementation
NO INTERVENTIONNSPs assigned to this arm would receive standard care (treatment as usual) and would not be exposed to the integrated HIV service model.
Interventions
BRIDGE, enhanced HIV service integration package, has three components: 1. peer driven recruitment using a Social Network Strategy (SNS) -- which has been designated as a "high impact and highly effective" strategy by the CDC for reaching out and engaging PWID in HIV testing 2. HCT using CTR with Rapid Testing 3. ARTAS -- a CDC case management strategy for linking HIV-positive PWID to HIV care that addresses specific barriers and gaps in HIV service delivery in NSPs
Eligibility Criteria
You may qualify if:
- positive confirmatory HIV test;
- aged 18 or older;
- report injecting any drug in the past 30 days; and
- have had one or more contacts with NSP staff at one of the 24 NSPs
You may not qualify if:
- show evidence of significant psychiatric or cognitive impairment that would limit effective participation as confirmed during informed consent;
- are not fluent in Russian or Kazakh as determined during informed consent; or
- have been previously screened for or enrolled in the study confirmed by fingerprint scan
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Columbia Universitylead
- National Institute on Drug Abuse (NIDA)collaborator
Study Sites (2)
Columbia University School of Social Work
New York, New York, 10027, United States
Global Health Research Center of Central Asia
Almaty, Kazakhstan
Related Publications (2)
El-Bassel N, McCrimmon T, Wu E, Chang M, Terlikbayeva A, Hunt T, Darisheva M, Primbetova S, Davis A, Metsch LR, Feaster DJ, Baiserkin B, Abishev A, Denebayeva A, Sagimbayev B, Kurmetova K, Mashirov K, Gilbert L. Effectiveness of an Intervention to Improve HIV Service Delivery for People Who Inject Drugs in Kazakhstan: A Cluster Trial. JAMA Netw Open. 2022 Dec 1;5(12):e2244734. doi: 10.1001/jamanetworkopen.2022.44734.
PMID: 36454567DERIVEDMcCrimmon T, Gilbert L, Hunt T, Terlikbayeva A, Wu E, Darisheva M, Primbetova S, Kuskulov A, Davis A, Dasgupta A, Schackman BR, Metsch LR, Feaster DJ, Baiserkin B, El-Bassel N. Improving HIV service delivery for people who inject drugs in Kazakhstan: study protocol for the Bridge stepped-wedge trial. Implement Sci. 2019 Jun 14;14(1):62. doi: 10.1186/s13012-019-0909-z.
PMID: 31200757DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Nabila El-Bassel, PhD
Columbia University
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- CROSSOVER
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Professor
Study Record Dates
First Submitted
June 7, 2016
First Posted
June 10, 2016
Study Start
February 1, 2017
Primary Completion
August 1, 2020
Study Completion
August 1, 2020
Last Updated
May 31, 2022
Record last verified: 2021-07