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Assessing a norming intervention to promote acceptance of HIV testing and reduce stigma during household tuberculosis contact investigation: protocol for a cluster-randomised trial

INTRODUCTION: HIV status awareness is important for household contacts of patients with tuberculosis (TB). Home HIV testing during TB contact investigation increases HIV status awareness. Social interactions during home visits may influence perceived stigma and uptake of HIV testing. We designed an...

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Autores principales: Armstrong-Hough, Mari, Ggita, Joseph, Gupta, Amanda J, Shelby, Tyler, Nangendo, Joanita, Ayen, Daniel Okello, Davis, J L, Katamba, Achilles
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9134160/
https://www.ncbi.nlm.nih.gov/pubmed/35613785
http://dx.doi.org/10.1136/bmjopen-2022-061508
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author Armstrong-Hough, Mari
Ggita, Joseph
Gupta, Amanda J
Shelby, Tyler
Nangendo, Joanita
Ayen, Daniel Okello
Davis, J L
Katamba, Achilles
author_facet Armstrong-Hough, Mari
Ggita, Joseph
Gupta, Amanda J
Shelby, Tyler
Nangendo, Joanita
Ayen, Daniel Okello
Davis, J L
Katamba, Achilles
author_sort Armstrong-Hough, Mari
collection PubMed
description INTRODUCTION: HIV status awareness is important for household contacts of patients with tuberculosis (TB). Home HIV testing during TB contact investigation increases HIV status awareness. Social interactions during home visits may influence perceived stigma and uptake of HIV testing. We designed an intervention to normalise and facilitate uptake of home HIV testing with five components: guided selection of first tester; prosocial invitation scripts; opt-out framing; optional sharing of decisions to test; and masking of decisions not to test. METHODS AND ANALYSIS: We will evaluate the intervention effect in a household-randomised controlled trial. The primary aim is to assess whether contacts offered HIV testing using the norming strategy will accept HIV testing more often than those offered testing using standard strategies. Approximately 198 households will be enrolled through three public health facilities in Kampala, Uganda. Households will be randomised to receive the norming or standard strategy and visited by a community health worker (CHW) assigned to that strategy. Eligible contacts ≥15 years will be offered optional, free, home HIV testing. The primary outcome, proportion of contacts accepting HIV testing, will be assessed by CHWs and analysed using an intention-to-treat approach. Secondary outcomes will be changes in perceived HIV stigma, changes in perceived TB stigma, effects of perceived HIV stigma on HIV test uptake, effects of perceived TB stigma on HIV test uptake and proportions of first-invited contacts who accept HIV testing. Results will inform new, scalable strategies for delivering HIV testing. ETHICS AND DISSEMINATION: This study was approved by the Yale Human Investigation Committee (2000024852), Makerere University School of Public Health Institutional Review Board (661) and Uganda National Council on Science and Technology (HS2567). All participants, including patients and their household contacts, will provide verbal informed consent. Results will be submitted to a peer-reviewed journal and disseminated to national stakeholders, including policy-makers and representatives of affected communities. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT05124665.
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spelling pubmed-91341602022-06-10 Assessing a norming intervention to promote acceptance of HIV testing and reduce stigma during household tuberculosis contact investigation: protocol for a cluster-randomised trial Armstrong-Hough, Mari Ggita, Joseph Gupta, Amanda J Shelby, Tyler Nangendo, Joanita Ayen, Daniel Okello Davis, J L Katamba, Achilles BMJ Open HIV/AIDS INTRODUCTION: HIV status awareness is important for household contacts of patients with tuberculosis (TB). Home HIV testing during TB contact investigation increases HIV status awareness. Social interactions during home visits may influence perceived stigma and uptake of HIV testing. We designed an intervention to normalise and facilitate uptake of home HIV testing with five components: guided selection of first tester; prosocial invitation scripts; opt-out framing; optional sharing of decisions to test; and masking of decisions not to test. METHODS AND ANALYSIS: We will evaluate the intervention effect in a household-randomised controlled trial. The primary aim is to assess whether contacts offered HIV testing using the norming strategy will accept HIV testing more often than those offered testing using standard strategies. Approximately 198 households will be enrolled through three public health facilities in Kampala, Uganda. Households will be randomised to receive the norming or standard strategy and visited by a community health worker (CHW) assigned to that strategy. Eligible contacts ≥15 years will be offered optional, free, home HIV testing. The primary outcome, proportion of contacts accepting HIV testing, will be assessed by CHWs and analysed using an intention-to-treat approach. Secondary outcomes will be changes in perceived HIV stigma, changes in perceived TB stigma, effects of perceived HIV stigma on HIV test uptake, effects of perceived TB stigma on HIV test uptake and proportions of first-invited contacts who accept HIV testing. Results will inform new, scalable strategies for delivering HIV testing. ETHICS AND DISSEMINATION: This study was approved by the Yale Human Investigation Committee (2000024852), Makerere University School of Public Health Institutional Review Board (661) and Uganda National Council on Science and Technology (HS2567). All participants, including patients and their household contacts, will provide verbal informed consent. Results will be submitted to a peer-reviewed journal and disseminated to national stakeholders, including policy-makers and representatives of affected communities. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT05124665. BMJ Publishing Group 2022-05-24 /pmc/articles/PMC9134160/ /pubmed/35613785 http://dx.doi.org/10.1136/bmjopen-2022-061508 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle HIV/AIDS
Armstrong-Hough, Mari
Ggita, Joseph
Gupta, Amanda J
Shelby, Tyler
Nangendo, Joanita
Ayen, Daniel Okello
Davis, J L
Katamba, Achilles
Assessing a norming intervention to promote acceptance of HIV testing and reduce stigma during household tuberculosis contact investigation: protocol for a cluster-randomised trial
title Assessing a norming intervention to promote acceptance of HIV testing and reduce stigma during household tuberculosis contact investigation: protocol for a cluster-randomised trial
title_full Assessing a norming intervention to promote acceptance of HIV testing and reduce stigma during household tuberculosis contact investigation: protocol for a cluster-randomised trial
title_fullStr Assessing a norming intervention to promote acceptance of HIV testing and reduce stigma during household tuberculosis contact investigation: protocol for a cluster-randomised trial
title_full_unstemmed Assessing a norming intervention to promote acceptance of HIV testing and reduce stigma during household tuberculosis contact investigation: protocol for a cluster-randomised trial
title_short Assessing a norming intervention to promote acceptance of HIV testing and reduce stigma during household tuberculosis contact investigation: protocol for a cluster-randomised trial
title_sort assessing a norming intervention to promote acceptance of hiv testing and reduce stigma during household tuberculosis contact investigation: protocol for a cluster-randomised trial
topic HIV/AIDS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9134160/
https://www.ncbi.nlm.nih.gov/pubmed/35613785
http://dx.doi.org/10.1136/bmjopen-2022-061508
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