HIV -1 Infection, HIV Viremia
Conditions
Keywords
Uncontrolled Viremia, Person Centred Care, Unmonitored Viral Load
Brief summary
The study aims to increase the reach of the person-centred interpersonal practices by developing and accessing a tailored, scalable, and sustainable approach that meets the distinctive needs of populations identified as most disproportionately affected by viremia in Zambia. The study population include pregnant and breastfeeding women, children, adolescents and adult that are more than thirty -30 days late for their next hospital appointments.The study will be implemented over a period of 36 months in 24 facilities in Lusaka and Central province, Zambia.
Detailed description
The study has three aims, that include (1) To assess barriers to sustained viral suppression through identifying prevailing pathways to viremia (2) Apply Human Centred Design methods with stakeholders to co-create person-centred pathways to strengthen viral suppression, with particular attention to vulnerable groups (3) To test P-CoRE package with a focus on high- priority populations contributing to remaining viremia.
Interventions
OTHERInterventions will be developed in aim 2 of the study.
Person-centred package that connects patients to service delivery, builds rapports and improves engagement in care leading to sustained viral load suppressions
Sponsors
Centre for Infectious Disease Research in Zambia
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
1. Patients that are lost to follow up (\[LTFU\] from HIV care i.e. confirmed \>30 days late for a scheduled appointment) at the time of sampling. (i.e. not people who were previously LTFU but then returned and have a documented VL.) 2. Individuals returning to care after being out of care and not taking ART with no VL measure (i.e., unmeasured viremia) 3. Patients that are 6 months late for a scheduled Viral Load (VL) according to Ministry of Health guidelines at the time of sampling (regardless of care status) 4. Patients that have a last documented VL that is elevated, \> 1000 copies/ml at time of sampling in current clinic population (CCP) (regardless of care status) 5. Participant that are willing to provide written informed consent in English, or any of the local languages that include Nyanja or Bemba.
Exclusion criteria
1. Patients that are unable to provide consent or unwilling to participate in the study 2. Participant who is NOT living with HIV/AIDS; 3. Participant is too sick i.e., failing to talk, general discomfort and emergency cases);
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Updated Estimates of Viremia and Care Status | 2 years | The study will use a sampling based approach for outcome ascertainment as used in the Better Information for Health in Zambia(BetterInfo) study https://www.cidrz.org/wp-content/toolkits/betterinfo/, but adapt procedures so they are focused on assessments of viremia (rather than mortality as in the initial BetterInfo study) (21). This approach leverages data collected during routine care and augments it with targeted data collection in a smaller sample of clients with incomplete data (i.e., missing VL measurements) to provide robust and epidemiologically rigorous estimates for the full clinic population. |
Countries
Zambia
Contacts
PRINCIPAL_INVESTIGATORDr Aaloke Mody
Washington University School of Medicine
PRINCIPAL_INVESTIGATORKombatende Sikombe
Centre for Infectious Disease Research in Zambia
Outcome results
None listed