Stigma-directed services (Stig2Health) to improve ‘linkage to care’ for people living with HIV in rural Tanzania: study protocol for a nested pre-post implementation study within the Kilombero and Ulanga Antiretroviral Cohort [version 2; peer review: 2 approved]
Background: HIV-related stigma is a major barrier to the timely linkage and retention of patients in HIV care in sub-Saharan Africa, where most people living with HIV/AIDS reside. In this implementation study we aim to evaluate the effect of stigma-directed services on linkage to care and other heal...
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| Format: | Article |
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F1000 Research Ltd
2022-08-01
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| Series: | Open Research Africa |
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| Online Access: | https://openresearchafrica.org/articles/5-14/v2 |
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| author | Raphael Magnolini Aneth Vedastus Kalinjuma Elizabeth Senkoro Bernard Kivuma Olivia Kitau Anna Eichenberger Leila Samson Eileen Krinke Getrud Joseph Mollel Robert Ndege James Okuma Herry Mapesi Tracy Glass Manuel Battegay Fiona Vanobberghen Maja Weisser |
| author_facet | Raphael Magnolini Aneth Vedastus Kalinjuma Elizabeth Senkoro Bernard Kivuma Olivia Kitau Anna Eichenberger Leila Samson Eileen Krinke Getrud Joseph Mollel Robert Ndege James Okuma Herry Mapesi Tracy Glass Manuel Battegay Fiona Vanobberghen Maja Weisser |
| author_sort | Raphael Magnolini |
| collection | DOAJ |
| description | Background: HIV-related stigma is a major barrier to the timely linkage and retention of patients in HIV care in sub-Saharan Africa, where most people living with HIV/AIDS reside. In this implementation study we aim to evaluate the effect of stigma-directed services on linkage to care and other health outcomes in newly diagnosed HIV-positive patients. Methods: In a nested project of the Kilombero and Ulanga Antiretroviral Cohort in rural Tanzania, we conduct a prospective observational pre-post study to assess the impact of a bundle of stigma-directed services for newly diagnosed HIV positive patients. Stigma-directed services, delivered by a lay person living with HIV, are i) post-test counseling, ii) post-test video-assisted teaching, iii) group support therapy and group health education, and iv) mobile health. Patients receiving stigma services (enrolled from 1st February 2020 to 31st August 2021) are compared to a historical control receiving the standard of care (enrolled from 1st July 2017 to 1st February 2019). The primary outcome is ‘linkage to care’. Secondary endpoints are retention in care, viral suppression, death and clinical failure at 6-12 months (up to 31st August 2022). Self-reported stigma and depression are assessed using the Berger Stigma scale and the PHQ-9 questionnaire, respectively. The sample size calculation was based on cohort data from 2018. Assuming a pre-intervention cohort of 511 newly diagnosed adults of whom 346 (68%) were in care and on antiretroviral treatment (ART) at 2 months, a 10% increase in linkage (from 70 to 80%), a two-sided type I error rate of 5%, and 90% power, 321 adults are required for the post-implementation group. Discussion: We expect that integration of stigma-directed services leads to an increase of proportions of patients in care and on ART. The findings will provide guidance on how to integrate stigma-directed services into routine care in rural sub-Saharan Africa. |
| format | Article |
| id | doaj-art-788ad4f628d642c6a61544df0ec77e17 |
| institution | Kabale University |
| issn | 2752-6925 |
| language | English |
| publishDate | 2022-08-01 |
| publisher | F1000 Research Ltd |
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| series | Open Research Africa |
| spelling | doaj-art-788ad4f628d642c6a61544df0ec77e172024-12-13T01:00:11ZengF1000 Research LtdOpen Research Africa2752-69252022-08-01514610Stigma-directed services (Stig2Health) to improve ‘linkage to care’ for people living with HIV in rural Tanzania: study protocol for a nested pre-post implementation study within the Kilombero and Ulanga Antiretroviral Cohort [version 2; peer review: 2 approved]Raphael Magnolini0https://orcid.org/0000-0002-4102-9139Aneth Vedastus Kalinjuma1Elizabeth Senkoro2Bernard Kivuma3https://orcid.org/0000-0001-9774-2577Olivia Kitau4Anna Eichenberger5Leila Samson6Eileen Krinke7https://orcid.org/0000-0002-9514-1900Getrud Joseph Mollel8Robert Ndege9https://orcid.org/0000-0002-1253-8970James Okuma10Herry Mapesi11Tracy Glass12Manuel Battegay13Fiona Vanobberghen14Maja Weisser15https://orcid.org/0000-0002-0134-1929Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, SwitzerlandIfakara Health Institute, Ifakara, TanzaniaIfakara Health Institute, Ifakara, TanzaniaIfakara Health Institute, Ifakara, TanzaniaIfakara Health Institute, Ifakara, TanzaniaIfakara Health Institute, Ifakara, TanzaniaIfakara Health Institute, Ifakara, TanzaniaUniversity Psychiatric Clinics Basel, Basel, SwitzerlandIfakara Health Institute, Ifakara, TanzaniaIfakara Health Institute, Ifakara, TanzaniaSwiss Tropical and Public Health Institute, Basel, SwitzerlandIfakara Health Institute, Ifakara, TanzaniaSwiss Tropical and Public Health Institute, Basel, SwitzerlandDivision of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, SwitzerlandSwiss Tropical and Public Health Institute, Basel, SwitzerlandDivision of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, SwitzerlandBackground: HIV-related stigma is a major barrier to the timely linkage and retention of patients in HIV care in sub-Saharan Africa, where most people living with HIV/AIDS reside. In this implementation study we aim to evaluate the effect of stigma-directed services on linkage to care and other health outcomes in newly diagnosed HIV-positive patients. Methods: In a nested project of the Kilombero and Ulanga Antiretroviral Cohort in rural Tanzania, we conduct a prospective observational pre-post study to assess the impact of a bundle of stigma-directed services for newly diagnosed HIV positive patients. Stigma-directed services, delivered by a lay person living with HIV, are i) post-test counseling, ii) post-test video-assisted teaching, iii) group support therapy and group health education, and iv) mobile health. Patients receiving stigma services (enrolled from 1st February 2020 to 31st August 2021) are compared to a historical control receiving the standard of care (enrolled from 1st July 2017 to 1st February 2019). The primary outcome is ‘linkage to care’. Secondary endpoints are retention in care, viral suppression, death and clinical failure at 6-12 months (up to 31st August 2022). Self-reported stigma and depression are assessed using the Berger Stigma scale and the PHQ-9 questionnaire, respectively. The sample size calculation was based on cohort data from 2018. Assuming a pre-intervention cohort of 511 newly diagnosed adults of whom 346 (68%) were in care and on antiretroviral treatment (ART) at 2 months, a 10% increase in linkage (from 70 to 80%), a two-sided type I error rate of 5%, and 90% power, 321 adults are required for the post-implementation group. Discussion: We expect that integration of stigma-directed services leads to an increase of proportions of patients in care and on ART. The findings will provide guidance on how to integrate stigma-directed services into routine care in rural sub-Saharan Africa.https://openresearchafrica.org/articles/5-14/v2HIV/AIDS Stigma Linkage to care HIV care Sub-Sahara Africa Study protocoleng |
| spellingShingle | Raphael Magnolini Aneth Vedastus Kalinjuma Elizabeth Senkoro Bernard Kivuma Olivia Kitau Anna Eichenberger Leila Samson Eileen Krinke Getrud Joseph Mollel Robert Ndege James Okuma Herry Mapesi Tracy Glass Manuel Battegay Fiona Vanobberghen Maja Weisser Stigma-directed services (Stig2Health) to improve ‘linkage to care’ for people living with HIV in rural Tanzania: study protocol for a nested pre-post implementation study within the Kilombero and Ulanga Antiretroviral Cohort [version 2; peer review: 2 approved] Open Research Africa HIV/AIDS Stigma Linkage to care HIV care Sub-Sahara Africa Study protocol eng |
| title | Stigma-directed services (Stig2Health) to improve ‘linkage to care’ for people living with HIV in rural Tanzania: study protocol for a nested pre-post implementation study within the Kilombero and Ulanga Antiretroviral Cohort [version 2; peer review: 2 approved] |
| title_full | Stigma-directed services (Stig2Health) to improve ‘linkage to care’ for people living with HIV in rural Tanzania: study protocol for a nested pre-post implementation study within the Kilombero and Ulanga Antiretroviral Cohort [version 2; peer review: 2 approved] |
| title_fullStr | Stigma-directed services (Stig2Health) to improve ‘linkage to care’ for people living with HIV in rural Tanzania: study protocol for a nested pre-post implementation study within the Kilombero and Ulanga Antiretroviral Cohort [version 2; peer review: 2 approved] |
| title_full_unstemmed | Stigma-directed services (Stig2Health) to improve ‘linkage to care’ for people living with HIV in rural Tanzania: study protocol for a nested pre-post implementation study within the Kilombero and Ulanga Antiretroviral Cohort [version 2; peer review: 2 approved] |
| title_short | Stigma-directed services (Stig2Health) to improve ‘linkage to care’ for people living with HIV in rural Tanzania: study protocol for a nested pre-post implementation study within the Kilombero and Ulanga Antiretroviral Cohort [version 2; peer review: 2 approved] |
| title_sort | stigma directed services stig2health to improve linkage to care for people living with hiv in rural tanzania study protocol for a nested pre post implementation study within the kilombero and ulanga antiretroviral cohort version 2 peer review 2 approved |
| topic | HIV/AIDS Stigma Linkage to care HIV care Sub-Sahara Africa Study protocol eng |
| url | https://openresearchafrica.org/articles/5-14/v2 |
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