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Feasibility of conducting HIV combination prevention interventions in fishing communities in Uganda: A pilot cluster randomised trial
OBJECTIVE: We assessed feasibility of an HIV-combination-prevention trial among fishing communities in Uganda. DESIGN: Cluster randomised trial in four fishing communities on Lake Victoria, Uganda. Two intervention communities received a combination-prevention-package (behaviour change communication...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436767/ https://www.ncbi.nlm.nih.gov/pubmed/30917121 http://dx.doi.org/10.1371/journal.pone.0210719 |
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author | Kuteesa, Monica O. Weiss, Helen A. Abaasa, Andrew Nash, Stephen Nsubuga, Rebecca N. Newton, Rob Seeley, Janet Kamali, Anatoli |
author_facet | Kuteesa, Monica O. Weiss, Helen A. Abaasa, Andrew Nash, Stephen Nsubuga, Rebecca N. Newton, Rob Seeley, Janet Kamali, Anatoli |
author_sort | Kuteesa, Monica O. |
collection | PubMed |
description | OBJECTIVE: We assessed feasibility of an HIV-combination-prevention trial among fishing communities in Uganda. DESIGN: Cluster 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. METHODS: Using 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. RESULTS: A 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 year, younger age, living in an urban area, and being away from the area for >1 month/year CONCLUSIONS: Recruitment 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. |
format | Online Article Text |
id | pubmed-6436767 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-64367672019-04-12 Feasibility of conducting HIV combination prevention interventions in fishing communities in Uganda: A pilot cluster randomised trial Kuteesa, Monica O. Weiss, Helen A. Abaasa, Andrew Nash, Stephen Nsubuga, Rebecca N. Newton, Rob Seeley, Janet Kamali, Anatoli PLoS One Research Article OBJECTIVE: We assessed feasibility of an HIV-combination-prevention trial among fishing communities in Uganda. DESIGN: Cluster 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. METHODS: Using 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. RESULTS: A 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 year, younger age, living in an urban area, and being away from the area for >1 month/year CONCLUSIONS: Recruitment 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. Public Library of Science 2019-03-27 /pmc/articles/PMC6436767/ /pubmed/30917121 http://dx.doi.org/10.1371/journal.pone.0210719 Text en © 2019 Kuteesa et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kuteesa, Monica O. Weiss, Helen A. Abaasa, Andrew Nash, Stephen Nsubuga, Rebecca N. Newton, Rob Seeley, Janet Kamali, Anatoli Feasibility of conducting HIV combination prevention interventions in fishing communities in Uganda: A pilot cluster randomised trial |
title | Feasibility of conducting HIV combination prevention interventions in fishing communities in Uganda: A pilot cluster randomised trial |
title_full | Feasibility of conducting HIV combination prevention interventions in fishing communities in Uganda: A pilot cluster randomised trial |
title_fullStr | Feasibility of conducting HIV combination prevention interventions in fishing communities in Uganda: A pilot cluster randomised trial |
title_full_unstemmed | Feasibility of conducting HIV combination prevention interventions in fishing communities in Uganda: A pilot cluster randomised trial |
title_short | Feasibility of conducting HIV combination prevention interventions in fishing communities in Uganda: A pilot cluster randomised trial |
title_sort | feasibility of conducting hiv combination prevention interventions in fishing communities in uganda: a pilot cluster randomised trial |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436767/ https://www.ncbi.nlm.nih.gov/pubmed/30917121 http://dx.doi.org/10.1371/journal.pone.0210719 |
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