Adults who are hospitalized in Lusaka, Zambia, and found to have advanced HIV disease will be enrolled and randomly assigned to receive the ARC intervention or standard of care. All participants will then be followed through the end of the hospitalization and for up to 1 year after discharge from hospital.
The ARC intervention includes support from a community health worker that begins during admission and continues after discharge to address gaps in the care cascade for HIV and serious coinfections and comorbidities. ARC components were previously developed and pilot tested at hospitals in Zambia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
724
ARC is a multi-component package of support delivered primarily by a community health worker. It is oriented towards the medical and psychosocial and sociobehavioral challenges of advanced HIV disease and hospitalization.
University Teaching Hospital
Lusaka, Zambia
All-cause mortality
Mortality will be ascertained as follows. All participants will receive monthly phone check-ins and if they don't respond a study staff member will trace their whereabouts in the community. This process will lead investigators to find out about deaths. In addition, investigators may be informed by a hospital staff member where a participant was admitted and died.
Time frame: Enrollment to up to 1 year
HIV viral suppression
HIV RNA concentration in plasma
Time frame: Enrollment, 3 months and 1 year
Retention in HIV care
No gap of \>28 days without documented possession of antiretroviral therapy medications
Time frame: At 3 months and 1 year
Medication possession ratio
Number of days with possession of antiretroviral medications divided by the time interval of interest
Time frame: At 3 months and 12 months
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