HIV service delivery, specifically HIV testing, treatment initiation, and retention in care Not Applicable
Conditions
Interventions
This was a two-arm study, with 1:1 randomization at performed among 20 health facilities to compare the impact of having Youth Health Africa (YHA) program interns on HIV service delivery, as measured
each randomization option had 10 facility names listed in “Group A” and 10 facility names listed in “Group B”. The randomization process was participatory. Ten golf balls of the same size and color we
the second person pulled a ball that would correspond to the second number of the randomization option, and so on. A fifth person picked a golf ball to determine whether Group A or Group B would be th
if ‘odd’, Group B would be
Sponsors
Aurum Institute
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Participant type: Health facilities. Health facilities were eligible for this study if they were: 1. Located in Ngaka Modiri Molema district 2. Offered HIV services as part of routine clinic programs/operations 3. Had never received interns from YHA 4. Collaborated with Aurum Institute as a PEPFAR implementing partner 5. Had a need for three interns (the minimum number of interns that would be placed in a clinic assigned to the intervention group) 6. Interested in participating in the intervention
Exclusion criteria
Exclusion criteria: 1. Not in Ngaka Modiri Molema district, North West province 2. Had previously received interns from YHA 3. Was not a partner of Aurum Institute 4. Was not perceived by healthcare leadership (facility leaders and district/sub-district leaders) to need three interns
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Aggregate (%) people tested for HIV, measured by the number of people tested for HIV / total number of people who visited the facility (measured by routinely collected variables: received HIV Testing Services (HTS)_ and received test results (TST) / Headcount) assessed in two ways: 1. Cumulative impact (difference-in-difference analysis): January - August 2020 versus January - August 2021 2. Monthly variation (controlled, interrupted time series analysis): October 2019 - Sept 2020 (Pre-intervention) versus October 2020 - August 2021 Data were routinely reported to The Aurum Institute from the facility through TIER.Net, South Africa’s national HIV surveillance system | — |
Secondary
| Measure | Time frame |
|---|---|
| Testing and Treatment Indicators: 1. % positive for HIV (Number testing positive for HIV / number tested for HIV) (measured by routinely collected variables: HTS_POS/ HTS_TST) 2. % initiated on treatment in 14 days (Number starting treatment within 14 days of HIV diagnosis/total diagnosed with HIV) (Measured by variables: INITIATED_14DAYS / HTS_POS) Retention Indicators: 3. % early default (Number who did not return for treatment within 28 days of appointment / Number on treatment) (Measured by variables: ART_DEFAULT_EARLY / TX_CURR90) 4. % late default (Number who did not return for treatment within 89 days of appointment / Number on treatment) (Measured by variables: ART_DEFAULT_LATE / TX_CURR90) 5. % loss to follow-up (Number of patients out of care for =90 days with no outcome / Number of treatments) (Measured by variables: ART_DEFAULT_ULTF / TX_CURR90) We assessed these outcomes in two ways: 1. Cumulative impact (difference-in-difference analysis): January - August 2020 versus January - August 2021 (Note: First few months of the trial were designated as a 'run-in' period and thus excluded from this part of the analysis). Note: Testing and treatment outcomes were aggregated across the eight-month baseline and study periods (e.g., % tested for HIV = total tested for HIV over 8 months / total headcount for 8 months). The denominator used to calculate retention outcomes could not be aggregated by month, so monthly means were calculated for the default and loss to follow-up outcomes for baseline and study periods. 2. Monthly variation (controlled, interrupted time series analysis): Time series containing October 2019 - September 2020 (Pre-intervention) versus October 2020 - August 2021 Tertiary Outcomes: 1. % of HIV testing among young people [aged 10-29 years old] (HIV testing among young people / all tested for HIV) 2. % of HIV testing among males (HIV testing in males / all tested for HIV) 3. % of HIV testing among young males (HIV testing in young males / a | — |
Countries
South Africa
Outcome results
None listed