HIV
Conditions
Keywords
HIV, Stigma, Social support, Social network, Kenya
Brief summary
This pilot study is a non-randomized controlled cohort study evaluating the impact of social network-based HIV education on antiretroviral therapy (ART) adherence, clinical outcomes, food security, social support, HIV knowledge, and risk behaviors among people living with HIV/AIDS, as well as members of their associated social support networks. The intervention, known as the Mfangano Health Net Microclinic Pilot Program, consists of a 6-month education program on HIV biology, interpersonal communication and community mobilization for both HIV positive individuals and their self-selected social network members selected irrespective of HIV status. Investigators hypothesize that participation in the microclinic program will improve ART adherence, cluster of differentiation 4 (CD4) count, social support, HIV knowledge and food insecurity and will reduce HIV-related stigma, as compared to participants in control communities.
Interventions
BEHAVIORALMfangano Health Net Microclinic Program
Educational program in which HIV positive individuals are invited to recruit their social networks to form 'microclinic' groups. These groups participate in a 6-month educational curriculum composed of information on HIV biology, interpersonal communication strategies and community mobilization. At the conclusion of the program, participants are encouraged to disclose their HIV status to members of their group through a facilitated disclosure process.
Sponsors
Organic Health Response
Microclinic International
Kenya Medical Research Institute
University of California, San Francisco
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* HIV positive patient on ART at Sena Health Center or member of patient's social network * Resident of Mfangano Island * 18 years of age or older * conversant in DhoLuo or English languages
Exclusion criteria
* none
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Antiretroviral therapy (ART) Adherence | change from baseline to 6-months | change in ART drug levels measured in small hair samples from baseline to 6 months |
| Disengagement from care | From time of study enrollment to first instance of 90-day gap in care, censorship (death, transfer outside study area) or end of study (up to 22 months) | Incidence of missing a clinic appointment by ≥90 days without having first transferred care to another clinic or died. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| HIV knowledge | change from baseline to 6-months | HIV knowledge as measured by HIV Knowledge Questionnaire (HIV-KQ-18) |
| Stigma | change from baseline to 6-months | stigma as measured by Parallel HIV/AIDS Stigma Scale (Attributed Stigma Attitudes) |
| ART adherence - end of study | change from baseline to end of study (22 months) | change in ART drug levels measured in small hair samples from baseline to end of study |
| Time in care | From time of study enrollment until study closure (22 months) or censorship (death or transfer of care to facility outside study area) | Proportion of time eligible for HIV care that patient is adherent to clinic appointment schedules. Calculated by subtracting the sum of all gaps in care from the total time eligible for care, and dividing by total time eligible for care. Gaps in care are defined as the number of days between a missed appointment and subsequent return to any clinic in the study area to access HIV care. |
| Social support | change from baseline to 6-months | Social support as measured by Duke-University of North Carolina (UNC) Functional Social Support Scale |
Countries
Kenya
Outcome results
None listed