The purpose of this randomized controlled trial is to compare a social network-based behavioral intervention known as microclinics to standard HIV clinical care alone in helping patients receiving HIV care on Mfangano, Remba and Ringiti Islands, Kenya remain adherent to clinic appointments. The study is designed to evaluate the effectiveness of microclinics on reducing gaps in clinical care, HIV viral load and HIV-related stigma, compared to standard HIV clinical care alone. By doing this research study, the investigators hope to learn whether microclinics are a useful social strategy for improving delivery of HIV treatment in rural Kenya.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
304
Individuals randomized to this arm will be invited to recruit members of their social network to form a health team, or microclinic. These groups will proceed through a discussion-based health education curriculum led by local community health workers. Topics will include HIV biology, medications, the importance of social support, and community outreach for reducing HIV stigma. The curriculum will conclude with an opportunity for all group members to disclose their HIV status to one another.
Ekialo Kiona Center
Mfangano Island, Homa Bay County, Kenya
Disengagement from care
Incidence of 90-day absence from care following a missed appointment
Time frame: 12 months
Disengagement from care
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.
Time frame: 12 months
Virologic suppression
Proportion of patients who are virologically suppressed 12 months after randomization
Time frame: 12 months
HIV-related stigma
Reduction in stigma as compared to baseline, measured by the Earnshaw HIV Stigma Framework
Time frame: 12 months
Re-engagement in care
Incidence of re-engagement in care following missed visit at time of study enrollment
Time frame: 12 months
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