Bibliographic Details
| Title: |
Reducing time to differentiated service delivery for newly diagnosed people living with HIV in Kigali, Rwanda: study protocol for a pilot, unblinded, randomised controlled study |
| Authors: |
Jonathan Ross, Marcel Yotebieng, Sarah Hill, Kathryn Anastos, Dominique Savio Habimana, Placidie Mugwaneza, Chenshu Zhang, Gad Murenzi, Athanase Munyaneza, Eric Remera, Charles Ingabire, Francine Umwiza, Benjamin Muhoza |
| Source: |
BMJ Open, Vol 11, Iss 4 (2021) |
| Publisher Information: |
BMJ Publishing Group, 2021. |
| Publication Year: |
2021 |
| Collection: |
LCC:Medicine |
| Subject Terms: |
Medicine |
| More Details: |
Introduction Current HIV guidelines recommend differentiated service delivery (DSD) models that allow for fewer health centre visits for clinically stable people living with HIV (PLHIV). Newly diagnosed PLHIV may require more intensive care early in their treatment course, yet frequent appointments can be burdensome to patients and health systems. Determining the optimal parameters for defining clinical stability and transitioning to less frequent appointments could decrease patient burden and health system costs. The objectives of this pilot study are to explore the feasibility and acceptability of (1) reducing the time to DSD from 12 to 6 months after antiretroviral therapy (ART) initiation,and (2) reducing the number of suppressed viral loads required to enter DSD from two to one.Methods and analyses The present study is a pilot, unblinded trial taking place in three health facilities in Kigali, Rwanda. Current Rwandan guidelines require PLHIV to be on ART for ≥12 months with two consecutive suppressed viral loads in order to transition to less frequent appointments. We will randomise 90 participants to one of three arms: entry into DSD at 6 months after one suppressed viral load (n=30), entry into DSD at 6 months after two suppressed viral loads (n=30) or current standard of care (n=30). We will measure feasibility and acceptability of this intervention; clinical outcomes include viral suppression at 12 months (primary outcome) and appointment attendance (secondary outcome).Ethics and dissemination This clinical trial was approved by the institutional review board of Albert Einstein College of Medicine and by the Rwanda National Ethics Committee. Findings will be disseminated through conferences and peer-reviewed publications, as well as meetings with stakeholders.Trial registration number NCT04567693. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2044-6055 |
| Relation: |
https://bmjopen.bmj.com/content/11/4/e047443.full; https://doaj.org/toc/2044-6055 |
| DOI: |
10.1136/bmjopen-2020-047443 |
| Access URL: |
https://doaj.org/article/96ae2909cb064c06af0d3dfe5efe4414 |
| Accession Number: |
edsdoj.96ae2909cb064c06af0d3dfe5efe4414 |
| Database: |
Directory of Open Access Journals |
