Addiction, HIV
Conditions
Brief summary
This research examines the effectiveness of an intervention that employs seek, test, and treat strategies for Vietnamese injection drug users (IDU) and their network members, by ensuring that high risk individuals are sought for HIV testing and promptly referred to and maintained on antiretroviral therapy (ART). HIV prevention interventions are provided to IDUs who test HIV-negative, as well as those who test HIV-positive. HIV-positive IDUs will be referred to HIV care through a two-arm randomized controlled trial to compare the effects of different levels of engagement in care on ART uptake, ART adherence, and treatment outcome.
Detailed description
Opioid injection and HIV infection are major public health problems in Vietnam. Injection drug users (IDUs) have a high burden of HIV infection (20% HIV prevalence, nationally; 6% mortality per year) and the high rate of HIV transmission continues (HIV incidence, 5% per year). The investigators propose an intervention that employs the seek, test, and treat strategies for the IDU population and their network members, by ensuring that high risk individuals are sought for HIV testing, promptly referred to and maintained on ART, while HIV prevention interventions provided to the many who test HIV-negative, as well as those who test HIV-positive. The intervention will seek and test IDUs and their network members in the community, particularly those who are recently released from drug treatment centers. HIV-positive IDUs will be referred to HIV care through a two arm randomized controlled trial to compare the effects of different levels of engagement in care on ART uptake, antiretroviral adherence, and treatment outcome.
Interventions
OTHERIntegrated methadone and antiretroviral therapy (iMART) clinic
Sponsors
Hanoi Center for HIV/AIDS Prevention and Control
Johns Hopkins University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age 18 years or older; 2. Recently released from drug treatment centers; 3. Positive HIV serology; 4. Male; 5. Meet criteria for ART initiation according to Vietnam's national guidelines; 6. Provide informed consent for the study; and 7. Reside in study area and do not plan to move away in the next 18 months.
Exclusion criteria
1. Currently on ART; 2. Co-enrollment in other HIV interventional research study; 3. Unwilling to provide locator information.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time from randomization to the initiation of antiretroviral therapy (ART) | At month 3 |
Secondary
| Measure | Time frame |
|---|---|
| CD4+ counts | At months 6, 12, and 18 |
| HIV-1 RNA levels | At months 6 and 12 |
Countries
Vietnam
Outcome results
None listed