Efficacy of an enhanced linkage to HIV care intervention at improving linkage to HIV care and achieving viral suppression following home-based HIV testing in rural Uganda: study protocol for the Ekkubo/PATH cluster randomized controlled trial.

摘要: Though home-based human immunodeficiency virus (HIV) counseling and testing (HBHCT) is implemented in many sub-Saharan African countries as part of their HIV programs, linkage to care remains a challenge. The purpose this study test an intervention enhance improve viral suppression among individuals positive during HBHCT rural Uganda. PATH (Providing Access To Care)/Ekkubo Study cluster-randomized controlled trial which compares the efficacy enhanced vs. standard-of-care (paper-based referrals) at achieving individual population-level suppression, intermediate outcomes care, receipt opportunistic infection prophylaxis, antiretroviral therapy initiation following HBHCT. Approximately 600 men women aged 18-59 who district-wide Uganda will be enrolled study. Villages (clusters) are pair matched by population size then randomly assigned or arm. teams visit households participants complete baseline questionnaire, receive testing, have blood drawn for load CD4 testing. At baseline, arm referrals including paper-based referral results via home 2 weeks later. Intervention session up three follow-up sessions home, booster clinic if they present care. These each last approximately 30 min consist help clients: identify reduce barriers engagement, disclose status, treatment supporter, overcome HIV-related stigma through links social support resources community. Participants both arms interviewer-administered questionnaires six 12 months follow-up, allow access medical records. findings can inform integration potentially cost-effective approach improving rates If effective, outcomes, mortality, its effect on load, decrease incidence. NCT02545673