Feasibility of conducting HIV combination prevention interventions in fishing communities in Uganda: A pilot cluster randomised trial
Feasibility of conducting HIV combination prevention interventions in fishing communities in Uganda: A pilot cluster randomised trial
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DOI：
10.1371/journal.pone.0210719
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发表时间：
2019-03-27
期刊：
影响因子：
3.7
通讯作者：
Kamali, Anatoli
中科院分区：
文献类型：
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作者：
Kuteesa, Monica O.;Weiss, Helen A.;Kamali, Anatoli
我们评估了在乌干达渔业社区中进行艾滋病毒联合预防试验的可行性。设计乌干达维多利亚湖四个渔业社区的聚类随机试验。两个干预社区收到了综合预防包（行为改变宣传、推广避孕套、艾滋病毒检测、自愿男性医学包皮环切术以及在艾滋病毒呈阳性的情况下转诊接受抗逆转录病毒治疗）。所有四个社区接受常规的政府艾滋病护理service.MethodsUsing住户普查数据，我们随机选择了一个队列的同意居民年龄>= 18岁。2014年7月进行了基线血清调查，随后于2015年3月和12月进行了两次重复调查。我们测量了艾滋病毒预防方法的使用情况、失访情况和艾滋病毒发病率，并考虑了多阶段调查设计。结果共有862名参与者入选并随访了15个月。对照组和干预组的参与率分别为62%和74%;总体失访率（LTFU）为21.6%，各组相似。两组基线和终点之间自我报告的禁欲/忠诚度均从53%增加到对照组的73%，在整个研究期间，干预组报告的安全套使用率为36%，对照组为28%;两组中报告包皮环切术的男性受试者数量在干预组中为58%至79%，在对照组中为39%至46%。失访的独立基线预测因素为：艾滋病毒阳性，在社区居住1个月/年结论在高度移动的艾滋病毒捕鱼社区招募和保留纵向试验的参与者具有挑战性。未来的研究应调查定位和留住参与者的模式，以及艾滋病毒预防组合的提供。
ObjectiveWe assessed feasibility of an HIV-combination-prevention trial among fishing communities in Uganda.DesignCluster randomised trial in four fishing communities on Lake Victoria, Uganda. Two intervention communities received a combination-prevention-package (behaviour change communication, condom promotion, HIV testing, voluntary male medical circumcision and referral for anti-retroviral therapy if HIV-positive). All four communities received routine government HIV care services.MethodsUsing household census data we randomly selected a cohort of consenting residents aged >= 18 years. A baseline sero-survey in July 2014 was followed by two repeat surveys in March and December 2015. We measured uptake of HIV prevention methods, loss-to-follow- up and HIV incidence, accounting for multistage survey design.ResultsA total of 862 participants were enrolled and followed for 15 months. Participation was 62% and 74% in the control and intervention arms respectively; Overall loss to follow up (LTFU) was 21.6% and was similar by arm. Self-reported abstinence/faithfulness increased between baseline and endline in both arms from 53% to 73% in the control arm, and 55% to 67% in the intervention arm. Reported condom use throughout the study period was 36% in the intervention arm vs 28% in the control arm; number of male participants reporting circumsicion in both arms from 58% to 79% in the intervention arm, and 39% to 46% in the control arm. Independent baseline predictors of loss-to-follow-up were: being HIV positive, residence in the community for 1 month/yearConclusionsRecruitment and retention of participants in longitudinal trials in highly mobile HIV fishing communities is challenging. Future research should investigate modes for locating and retaining participants, and delivery of HIV-combination prevention.