Strategies to uncover undiagnosed HIV infection among heterosexuals at high risk and link them to HIV care with high retention: a “seek, test, treat, and retain” study

BMC Public Health

Study Protocol

Samuel Jenness¹  David C. Perlman²  Angela Banfield³  Belkis Y. Martinez³  Noelle R. Leonard³  Holly Hagan³  Katharine Ha³  Talaya McCright-Gill³  Amanda S. Ritchie³  Marya Gwadz³  Charles M. Cleland³  Mindy Belkin³  Elizabeth Applegate³  Montserrat Del Olmo³  Bridget Cross³  Alexandra Kutnick³  Quentin L. Swain³  Ann E. Kurth³ 

[1] Department of Epidemiology, University of Washington, Box 357236, 98195, Seattle, WA, USA;Mount Sinai Beth Israel, Baron Edmond de Rothschild Chemical Dependency Institute, 120 Water Street, Floor 24, 10038, New York, NY, USA;NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, 10010, New York, NY, USA;

关键词: Protocol;    Health status disparities;    HIV;    Undiagnosed HIV;    Engagement in care;    Venue-based sampling;    Respondent-driven sampling;    Peer-driven intervention;    African American;    Latino;   

DOI  :  10.1186/s12889-015-1816-0

 received in 2015-04-17, accepted in 2015-05-01,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundOver 50,000 individuals become infected with HIV annually in the U.S., and over a quarter of HIV infected individuals are heterosexuals. Undiagnosed HIV infection, as well as a lack of retention in care among those diagnosed, are both primary factors contributing to ongoing HIV incidence. Further, there are racial/ethnic disparities in undiagnosed HIV and engagement in care, with African Americans/Blacks and Latinos remaining undiagnosed longer and less engaged in care than Whites, signaling the need for culturally targeted intervention approaches to seek and test those with undiagnosed HIV infection, and link them to care with high retention.Methods/DesignThe study has two components: one to seek out and test heterosexuals at high risk for HIV infection, and another to link those found infected to HIV care with high retention. We will recruit sexually active African American/Black and Latino adults who have opposite sex partners, negative or unknown HIV status, and reside in locations with high poverty and HIV prevalence. The “Seek and Test” component will compare the efficacy and cost effectiveness of two strategies to uncover undiagnosed HIV infection: venue-based sampling and respondent-driven sampling (RDS). Among those recruited by RDS and found to have HIV infection, a “Treat and Retain” component will assess the efficacy of a peer-driven intervention compared to a control arm with respect to time to an HIV care appointment and health indicators using a cluster randomized controlled trial design to minimize contamination. RDS initial seeds will be randomly assigned to the intervention or control arm at a 1:1 ratio and all recruits will be assigned to the same arm as the recruiter. Participants will be followed for 12 months with outcomes assessed using medical records and biomarkers, such as HIV viral load.DiscussionHeterosexuals do not test for HIV as frequently as and are diagnosed later than other risk groups. The study has the potential to contribute an efficient, innovative, and sustainable multi-level recruitment approach and intervention to the HIV prevention portfolio. Because the majority of heterosexuals at high risk are African American/Black or Latino, the study has great potential to reduce racial/ethnic disparities in HIV/AIDS.Trial registrationClinicalTrials.gov, NCT01607541, Registered May 23, 2012.

【 授权许可】

CC BY   
© Gwadz et al.; licensee BioMed Central. 2015