SNS to Increase HIV Testing Uptake and Linkage to Double Cascade Services Among Adolescent MSM and TGW in Thailand

NCT04953858 | Completed

• 1 other identifier: SNS project
• Study Type: interventional
• Target: 202
• Locations: 1 country
• Sites: 1

Brief Summary

UNAIDS aims to end AIDS by 2030 using "90-90-90" diagnosis-treatment-viral suppression targets. Thailand has achieved elimination of HIV mother-to-child transmission, but continues to see new infections among adolescent men who have sex with men (YMSM) and transgender women (YTGW). Reaching and engagement of key populations to HIV services remains a major challenge, with differentiated care needed to address this. Investigators propose a study on outreach for HIV at-risk adolescents using peer-led social network strategies (SNS), linkage to facility-based HIV self-testing, and same day HIV prevention or treatment. The study will focus on the 15-19 year age group who have the highest HIV incidence in Thailand (6.9-10 per 100 person years, PY), but will also include young adults aged 20- 24 years of age, due to their frequently intertwining sex networks and very similar HIV incidence of 4.9-7.2 per 100 PY. Eight hundred adolescent and young adult (AYA) MSM and TGW aged between 15-24 years will be recruited into a double HIV cascade care system. AYA aged between 15-24 years will be trained as recruiters to approach and refer their peers, 'network members' (NMs) to our adolescent clinic. NMs will be offered a choice of either blood-based or oral fluid-based HIV self-testing. HIV positive cases will be offered same-day antiretroviral therapy (SDART) and high-risk adolescents will be offered same day preexposure prophylaxis (PrEP). The project will be conducted at adolescent differentiated care services previously established by CIPHER grants in Thailand, located at King Chulalongkorn Memorial Hospital (KCMH), Bangkok. It will inform both Thailand and other Asia-Pacific region countries with similar epidemic patterns through an implementation research lens on strategies to engage YMSM and YTGW into HIV services, which investigators believe will make high-impact contributions to our collective ultimate goal of ending AIDS.

Conditions

Social Network Strategy; HIV Self Testing; Men Who Have Sex With Men

Outcome Measures

Primary Outcomes (1)

• The effectiveness of using social network strategies to increase HIV testing uptake in YMSM and YTGW.

  Effectiveness will be measured by proportion of first-time testers among participants enrolled, defined as number of first-time testers divided by total number enrolled. SNS strategies are considered effective when proportions exceed 50 percent. Descriptive statistics of first-time tester characteristics, HIV risk factors, and their recruiter's characteristics will be described.

  24 months

Secondary Outcomes (2)

• Pre-exposure prophylaxis (PrEP) uptake among HIV negative at-risk adolescents

  24 months

• Viral suppression at 6 months for those initiated on antiretroviral treatment among newly diagnosed HIV positive adolescents

  24 months

Study Arms (1)

Social Network Strategy

OTHER

All study participants will receive social network strategy intervention as linkage method to receive HIV testing and care

Other: Social network strategy (SNS)

Interventions

Social network strategy (SNS) OTHER

SNS utilizes peers to reach and recruit their network members into HIV services, therefore having the advantage that recruiters with different behavioral risks and HIV statuses are likely to have access to a wide variety of HIV at risk populations

Social Network Strategy

Eligibility Criteria

• Age: 15 Years - 24 Years
• Gender Eligibility Details: Men who have sex with men (MSM) or transgender women (TGW)
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• ages 15-24 years
• assigned male gender at birth
• self-defined gender identity of either MSM or TGW
• any one of the following: living with HIV, using HIV pre-exposure prophylaxis, receiving intermittent HIV testing for ongoing HIV risk
• good rapport with King Chulalongkorn Memorial Hospital (KCMH) Adolescent Health Clinic, knowledgable on HIV and comfortable discussing HIV with peers
• Network Members
• ages 15-24 years
• assigned male gender at birth
• self-defined gender identity of either MSM or TGW
• self-reported oral and/or anal sex with a man in the past 12 months and at risk of HIV infection (multiple sex partners in the preceding 6 months and/or inconsistent condom use)
• no history of HIV testing or last HIV test \> 3 months prior to study entry

You may not qualify if:

• Known to be living with HIV

Sponsors & Collaborators

• Chulalongkorn University: lead

Study Sites (1)

The Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University

Bangkok, Thailand

Location

MeSH Terms

Conditions

Homosexuality

Condition Hierarchy (Ancestors)

Sexuality; Sexual Behavior; Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Potential recruiters will be approached in routine adolescent HIV treatment and services and those enrolled will approach peers to become network members who then come in for HIV testing

Study Record Dates

• First Submitted: May 4, 2021
• First Posted: July 8, 2021
• Study Start: April 1, 2021
• Primary Completion: March 31, 2022
• Study Completion: March 31, 2022
• Last Updated: September 11, 2023

Record last verified: 2021-04

Locations

TH (1)