Improving access to health services for populations at higher risk for HIV infection in Tanzania

ISRCTN ISRCTN11126469
DOI https://doi.org/10.1186/ISRCTN11126469
Secondary identifying numbers 16-P03-TAN
Submission date
27/08/2019
Registration date
28/08/2019
Last edited
08/11/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Infections and Infestations
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English Summary

Background and study aims
HIV/AIDS has rolled back decades of socio-economic development in Sub Saharan Africa. While there are indications of declining HIV infection rates in the general population, men who have sex with men (MSM), female sex workers (FSW) and people who inject drugs (PWIDS), now called Key Populations (KP) for HIV epidemic have 2-20 times higher infections rates and contributes up to 30% of new HIV infection. Despite such high infection rates, only a third has access to health services due to stigma and discriminations. The overall objective of this study is to increase access to health services among key populations through studying factors which influence the use of health services among them and test the effectiveness of healthcare worker and peer to peer engagement in improving access to comprehensive HIV intervention package among HIV at-risk population in Tanzania.

Who can participate?
Adults who inject drugs, men who regularly or occasionally engage in sexual relationships with other men, women who exchange sex for goods or money and healthcare workers.

What does the study involve?
The study involves the promotion of key population friendly facilities through training of healthcare workers on the comprehensive HIV intervention package and developing a cadre of peers to support health access. This will be done in Dar es salaam as an intervention region and Tanga region will be used as a control region.

What are the possible benefits and risks of participating?
Enrolling in the study will improve access to health services among study participants hence better health.

Where is the study run from?
The study will take place at the Muhimbili University of health and Allied Sciences Dar es salaam, Tanzania.

When is the study starting and how long is it expected to run for?
The study is planned to take place from May, 2017 to April, 2021.

Who is funding the study?
The Danida Fellowship Centre (DFC) through grant No 16-P03-TAN.

Who is the main contact?
Prof. Elia John Mmbaga (eliajelia@yahoo.co.uk).

Contact information

Prof Elia John Mmbaga
Scientific

Muhimbili University of Health and Allied Sciences
9 United nations Road
P.O.Box 65015
Dar es Salaam
-
Tanzania

ORCiD logoORCID ID 0000-0003-3768-0225
Phone +255 22 250302
Email ejohn@muhas.ac.tz

Study information

Study designQuasi Experimental Design
Primary study designInterventional
Secondary study designNon randomised study
Study setting(s)Community
Study typePrevention
Participant information sheet Not available in web format, please use contact details to request a participant information sheet
Scientific titleAccess to health services for key populations in Tanzania: a quasi-experimental design
Study acronymDANIDA KP
Study hypothesis1. An interplay between individual, interpersonal, contextual, structural, and sociocultural and health system factors influence health service access among KP.
2. Integration of CHPs in the existing health system is feasible, sustainable and cost-effective.
3. Intervention delivery modalities developed by and for KP sustainably improve access to CHIPs for KP.
4. Building KP research capacity through masters and PhD training will increase the generation of new evidence and intervention evaluation.
Ethics approval(s)Approved 15/03/2016, Muhimbili University of Health and Allied Sciences Ethics Committee (P.O.Box 65001; 022 2152489; drp@muhas.ac.tz), ref: 2016-03/AEC/Vol. IX/197.
ConditionHIV infection
InterventionHealthcare workers Training
Selected health care workers will be trained on the delivery of the comprehensive Intervention package for HIV which will include modules on prevention, HIV and STI testing, HIV treatment with ART, psychosocial counselling and violence mitigation.

Peer-to peer mentoring
Selected members of the key population will be trained and peer mentors on how to navigate their fellows to health facilities, linkage to KP friendly facilities and violence prevention.

Training timing
Training will be done during the second year and booster training is done after 12 months of follow up.

Participants follow up
Participants will be followed up after 12 months and 24 months following the intervention.
Intervention typeBehavioural
Primary outcome measureThe proportion of the population at risk accessing HIV services is determined using questionnaire (if one has ever gone to a health facility during the past 12 months when one had STI or general conditions) at baseline, month 12 and 24 following the intervention.
Secondary outcome measures1. Safer sexual behaviors are measured using Questionnaire (condom use at last sexual act, number of sexual partners past 12 months at baseline, months 12 and 24 following the intervention.
2. Number of PhD trained is measured using project records on the number of project affiliated PhD graduates at the end of the project (months 60).
3. Integration of high-risk group services into the existing health system is measured using health facility records of the number of health care workers and the number of the key population seeking services in the 4 selected health facilities involved in the project at baseline, month 12 and month 24.
Overall study start date01/05/2017
Overall study end date30/04/2021

Eligibility

Participant type(s)Other
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants900 in intervention region and 900 from the control region (Total 1800)
Participant inclusion criteria1. Aged 18 or above and injects drugs.
2. Men who regularly or occasionally engage in sexual relationships with other men aged 18 and above.
3. Women who exchange sex for goods or money.
4. Health care workers aged 18 or above.
Participant exclusion criteria1. Refuse to provide informed consent.
2. Not a resident of a participting region.
2.1. Do not have and address and have not lived there for the past six months.
3. Have mental illness or are too sick to participate.
Recruitment start date01/11/2017
Recruitment end date31/03/2021

Locations

Countries of recruitment

  • Tanzania

Study participating centre

Muhimbili University of Health and Allied Sciences
P.o.Box 65016
9 United Nation Road
Dar es Salaam
+255
Tanzania

Sponsor information

Danida Fellowship Centre DFC
Research council

Hostrupsvej 22
Frederiksberg
1950
Denmark

Phone +45 3536 1322
Email research@dfcentre.dk
Website https://dfcentre.com/about-us/contact/
ROR logo "ROR" https://ror.org/05qvpbw57

Funders

Funder type

Research council

Danida Fellowship Centre
Private sector organisation / Other non-profit organizations
Alternative name(s)
DFC
Location
Denmark

Results and Publications

Intention to publish date01/04/2019
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination plan1. Key population Community Advisory Board
2. Local and International Conferences
3. Local Internation seminars and symposium
4. Peer reviewied Journal Publication
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from Prof. Elia John Mmbaga (eliajelia@yahoo.co.uk). Quantitative and qualitative data anonymized and will be available after publications or end of project on reasonable request.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 06/11/2019 08/11/2019 Yes No

Editorial Notes

08/11/2019: Publication reference added.
28/08/2019: Trial's existence confirmed by the Danida Fellowship Centre.

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