HIV/AIDS
Conditions
Brief summary
Consistent treatment with anti-retroviral therapy (ART) suppresses viral load (VL), prolonging life and improving quality of life for HIV+ persons. Suppressing VL benefits communities by reducing transmission to others. Mere availability of ART and care, however, is insufficient; the benefits of ART depend upon HIV+ persons' continuous visits to the health care provider, regular monitoring and regular delivery of medications, - known as retention in HIV care. In spite of national efforts, up to a quarter of HIV+ persons, especially low-income minorities are out of care. Innovative interventions are therefore urgently needed to maximize engagement and retention in HIV care, self-reported adherence, as well as HIV-1 RNA viral load suppression. In pursuit of these aims, the proposed study will assess outcomes of the following interventions in comparison to usual care: 1) contingency management (CM) only; 2) peer navigation (PN) only; and 3) a combined approach that integrates both CM and PN (CA) which the investigators hypothesize to be most effective in improving HIV clinical outcomes.
Interventions
BEHAVIORALCombined Contingency Management and Peer Navigation
BEHAVIORALContingency Management
BEHAVIORALPeer Navigation
Sponsors
University of California, Los Angeles
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Diagnosed HIV+ 2. Age 18 years or older 3. English or Spanish speaking 4. Residence in Los Angeles County 5. prescribed ART in prior 24 months 6. \< 3 visits in prior 12 months or have detectable viral load, as identified in the Ryan White CaseWatch database
Exclusion criteria
Not meeting any of the criteria identified above
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in retention-in-care behaviors over 12 months | Basline, follow-ups at month 2, 6, 12 | Using a 2x2 factorial design, to examine the effect of the three interventions -- peer navigation, contingency management, combined approach and usual care -- and evaluate how well they improve retention in HIV care |
| Change in HIV RNA viral load suppression and medication adherence over 12 months | Basline, follow-ups at month 2, and 12 | Using the same design, to examine the effects of the PN, CM and, CA interventions on HIV RNA viral load suppression and self-reported adherence |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cost effectiveness | 5 years | A secondary aim is to examine the cost-offset and potential cost-effectiveness of each intervention compared with usual care |
Countries
United States
Outcome results
None listed