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Innovative Strategy to Offer Online Test and Treat for Thai MSM/TG

Primary Purpose

HIV/AIDS

Status
Completed
Phase
Not Applicable
Locations
Thailand
Study Type
Interventional
Intervention
Group A: Offline HTC
Group B1: Offline HIV testing and post-test counseling
Group B2: Online HIV testing and post-test counseling
Sponsored by
Thai Red Cross AIDS Research Centre
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional screening trial for HIV/AIDS focused on measuring HIV home testing

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)MaleAccepts Healthy Volunteers

Inclusion Criteria:

  1. Thai national
  2. Age >18 years
  3. Men or transgender women who have at least 1 unprotected anal sex with men within the past 6 months
  4. Live in the Bangkok Metropolitan Region (Bangkok, Pathumthani, Samutprakarn, Samutsakorn, Nakornpathom and Nonthaburi) or Pattaya
  5. Not known to be HIV-positive, i.e., never tested for HIV or previous HIV test(s) negative
  6. Willing to participate in the study for 12 months.
  7. Provide verbal informed consent

Exclusion Criteria:

1. Known HIV-positive serostatus

Sites / Locations

  • The Thai Red Cross AIDS Research Centre

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Other

Other

Other

Arm Label

A:Offline HIV testing and counseling

B1:Offline

B2: Online

Arm Description

Participants in Group A will be invited to come to the Thai Red Cross Anonymous Clinic, RSAT or SWING drop-in centers in Bangkok, or SWING or Sisters drop-in centers in Pattaya. After registration, they will receive standard HIV Testing and Counseling (HTC) services.

participants will be guided to access services at the 'Adam's Love Offline Clinic,' a clinic set up specifically to provide private and fast HIV testing and post-test counseling only.

participants will be mailed a rapid HIV test kit. A trained online counselor will guide the participant through an online HIV testing process which includes quality checking of the test kit, obtaining blood through finger prick, performing the testing steps, and reading the test result.

Outcomes

Primary Outcome Measures

The proportion of first-time HIV testers, proportion of successful HIV tests completed, proportion of successful referral to HIV treatment, and retention rate.
The first-time HIV testers, successful HIV tests completed and successful referral to HIV treatment are the categorical data which don't have the units to measure. These variables are the binary outcome in which there are only two possible status e.g. yes or no, therapeutic successes or failure. The details are as follows: The first-time HIV testers: this outcome variable is collected from the questionnaire; the probability of the outcome is likely to be "yes" or "no". Successful HIV tests completed: this outcome variable is collected form the result of the laboratory; the probability of the outcome is likely to be "complete" or "incomplete". Successful referral to HIV treatment: this outcome variable is collected form the confirmation of antiretroviral treatment; the probability of the outcome is likely to be "successful" or "failure". Therefore frequency and proportions of participants who have the possible outcome that we are interested (who are the first HIV testers, who

Secondary Outcome Measures

The proportion of HIV-positive participants who have virological suppression at each study visit after initiating ART.
The proportion of HIV-positive participants who have virological suppression at each study visit after initiating ART among MSM and TG who access online vs. offline services will be reported together with 95% confidence intervals. Formal comparisons between groups will be made using a Chi-squared test.
The retention rates of HIV-negative MSM and TG for repeated HIV testing and HIV-positive MSM and TG for antiretroviral treatment when online vs. offline retention methods are used
The retention rate (or event-free survival functions) is the probability value that participant will remain in the study in any time point. The probability value is between 0 to 100% and will be estimated using Kaplan-Meier method for overall and separately by HIV-status and arms. Formal comparisons between HIV-status, online and offline retention arms will be made by a log-rank test.
The factors associated with the preferences for the online option of HIV pre-test counseling, HIV testing and post-test counseling, referral for HIV treatment, and retention services among MSM and TG
The association of covariates with a preference for online vs. offline services at first visit will be modeled using logistic regression. Predictor covariates will include socio-demographic data, sexual and drug use behaviors, social network characteristics, perceived barriers and facilitators for HIV testing, beliefs and experiences around stigma and discrimination related to HIV and/or being MSM or TG, strengths and supports for stigma/discrimination, and HIV testing history.

Full Information

First Posted
May 25, 2017
Last Updated
July 8, 2021
Sponsor
Thai Red Cross AIDS Research Centre
Collaborators
amfAR GMT Implementation Research Grant
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1. Study Identification

Unique Protocol Identification Number
NCT03203265
Brief Title
Innovative Strategy to Offer Online Test and Treat for Thai MSM/TG
Official Title
Thai Red Cross AIDS Research Centre (TRCARC)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Completed
Study Start Date
April 6, 2015 (Actual)
Primary Completion Date
June 1, 2021 (Actual)
Study Completion Date
July 1, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Thai Red Cross AIDS Research Centre
Collaborators
amfAR GMT Implementation Research Grant

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will ask Thai MSM and transgender women (TG) participants to self-select to participate in one of the 3 different study groups which provide various degrees of integrated online interventions and offline interventions for the Recruit-Test-Treat-Retain for HIV prevention and care among 3 groups (A, B1 and B2). All participants will be followed up either offline or online for 12 months. HIV-negative participants will be scheduled for repeat HTC at months 6 and 12. HIV-positive participants will be scheduled either offline or online to review their treatment history at months 6 and 12. HIV-negative participants in Group B1 and B2 can choose again at months 6 and 12 to switch from the online to offline, and vice versa, at the HIV testing/post-test counseling step and the referral to HIV treatment step

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV/AIDS
Keywords
HIV home testing

7. Study Design

Primary Purpose
Screening
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Prospective study to evaluate the first-time HIV testing, successful referral to HIV treatment, retention HIV testing among 3 different study groups. A participants will receive offline HIV testing,counseling and conventional retention strategies. HIV-positive result in A can choose to have either online or offline to HIV treatment. B1 participants will be guided to access services at the 'Adam's Love Clinic, that set up specifically to provide private, fast HIV testing and post-test counseling. B2 participants will be mailed a rapid HIV test kit. Counselor will guide the participant through an online HIV testing process. Post-test counseling will provided HIV test result online. Participants can choose one of two HIV testing and post-test counseling options. HIV-positive participants in B1 and B2 can choose again to refer to HIV treatment either online or offline. All participants in B1 and B2 will receive an online retention strategy.
Masking
Participant
Allocation
Non-Randomized
Enrollment
600 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
A:Offline HIV testing and counseling
Arm Type
Other
Arm Description
Participants in Group A will be invited to come to the Thai Red Cross Anonymous Clinic, RSAT or SWING drop-in centers in Bangkok, or SWING or Sisters drop-in centers in Pattaya. After registration, they will receive standard HIV Testing and Counseling (HTC) services.
Arm Title
B1:Offline
Arm Type
Other
Arm Description
participants will be guided to access services at the 'Adam's Love Offline Clinic,' a clinic set up specifically to provide private and fast HIV testing and post-test counseling only.
Arm Title
B2: Online
Arm Type
Other
Arm Description
participants will be mailed a rapid HIV test kit. A trained online counselor will guide the participant through an online HIV testing process which includes quality checking of the test kit, obtaining blood through finger prick, performing the testing steps, and reading the test result.
Intervention Type
Other
Intervention Name(s)
Group A: Offline HTC
Intervention Description
Offline or online referral to HIV treatment facility HIV-positive participants can choose to receive either an offline or online referral to HIV treatment facilities. An offline referral method usually includes a referral letter and/or a telephone call, followed by a series of calls to participants to ensure successful referral. Those who choose an online referral will be able to register online with an HIV treatment facility which provides ART without cost under the national programs. Participants will receive a registration code which will allow them to access HIV treatment clinics directly without the need to go through the regular registration and appointment system at that facility.
Intervention Type
Other
Intervention Name(s)
Group B1: Offline HIV testing and post-test counseling
Intervention Description
participants will be guided to access services at the 'Adam's Love Offline Clinic,' a clinic set up specifically to provide private and fast HIV testing and post-test counseling only referred from the Adam's Love Online Clinic.
Intervention Type
Other
Intervention Name(s)
Group B2: Online HIV testing and post-test counseling
Intervention Description
A trained online counselor will guide the participant through an online HIV testing process which includes quality checking of the test kit,obtaining blood through finger prick,performing the testing steps,reading the test result. A positive result from the first test will trigger the need for referral to confirmatory tests. The provisional nature of the positive result from the single rapid HIV test will be emphasized but the urgency to get immediate confirmatory tests and linkage to HIV treatment facilities will encouraged and supported. HIV positive test result will be confirmed only with three positive tests. Any online testing session with uncertain qualities at any step will be repeated at a later time or the participant will be offered offline HIV testing.
Primary Outcome Measure Information:
Title
The proportion of first-time HIV testers, proportion of successful HIV tests completed, proportion of successful referral to HIV treatment, and retention rate.
Description
The first-time HIV testers, successful HIV tests completed and successful referral to HIV treatment are the categorical data which don't have the units to measure. These variables are the binary outcome in which there are only two possible status e.g. yes or no, therapeutic successes or failure. The details are as follows: The first-time HIV testers: this outcome variable is collected from the questionnaire; the probability of the outcome is likely to be "yes" or "no". Successful HIV tests completed: this outcome variable is collected form the result of the laboratory; the probability of the outcome is likely to be "complete" or "incomplete". Successful referral to HIV treatment: this outcome variable is collected form the confirmation of antiretroviral treatment; the probability of the outcome is likely to be "successful" or "failure". Therefore frequency and proportions of participants who have the possible outcome that we are interested (who are the first HIV testers, who
Time Frame
1 Years
Secondary Outcome Measure Information:
Title
The proportion of HIV-positive participants who have virological suppression at each study visit after initiating ART.
Description
The proportion of HIV-positive participants who have virological suppression at each study visit after initiating ART among MSM and TG who access online vs. offline services will be reported together with 95% confidence intervals. Formal comparisons between groups will be made using a Chi-squared test.
Time Frame
1 Years
Title
The retention rates of HIV-negative MSM and TG for repeated HIV testing and HIV-positive MSM and TG for antiretroviral treatment when online vs. offline retention methods are used
Description
The retention rate (or event-free survival functions) is the probability value that participant will remain in the study in any time point. The probability value is between 0 to 100% and will be estimated using Kaplan-Meier method for overall and separately by HIV-status and arms. Formal comparisons between HIV-status, online and offline retention arms will be made by a log-rank test.
Time Frame
1 Years
Title
The factors associated with the preferences for the online option of HIV pre-test counseling, HIV testing and post-test counseling, referral for HIV treatment, and retention services among MSM and TG
Description
The association of covariates with a preference for online vs. offline services at first visit will be modeled using logistic regression. Predictor covariates will include socio-demographic data, sexual and drug use behaviors, social network characteristics, perceived barriers and facilitators for HIV testing, beliefs and experiences around stigma and discrimination related to HIV and/or being MSM or TG, strengths and supports for stigma/discrimination, and HIV testing history.
Time Frame
1 Years

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Thai national Age >18 years Men or transgender women who have at least 1 unprotected anal sex with men within the past 6 months Live in the Bangkok Metropolitan Region (Bangkok, Pathumthani, Samutprakarn, Samutsakorn, Nakornpathom and Nonthaburi) or Pattaya Not known to be HIV-positive, i.e., never tested for HIV or previous HIV test(s) negative Willing to participate in the study for 12 months. Provide verbal informed consent Exclusion Criteria: 1. Known HIV-positive serostatus
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nittaya Phanuphak, MD, PhD
Organizational Affiliation
Thai Red Cross AIDS Research Centre (TRCARC)
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Thai Red Cross AIDS Research Centre
City
Pathum Wan
State/Province
Bangkok
ZIP/Postal Code
10330
Country
Thailand

12. IPD Sharing Statement

Citations:
PubMed Identifier
31960589
Citation
Phanuphak N, Jantarapakde J, Himmad L, Sungsing T, Meksena R, Phomthong S, Phoseeta P, Tongmuang S, Mingkwanrungruang P, Meekrua D, Sukthongsa S, Hongwiangchan S, Upanun N, Jirajariyavej S, Jadwattanakul T, Barisri S, Pankam T, Phanuphak P. Linkages to HIV confirmatory testing and antiretroviral therapy after online, supervised, HIV self-testing among Thai men who have sex with men and transgender women. J Int AIDS Soc. 2020 Jan;23(1):e25448. doi: 10.1002/jia2.25448.
Results Reference
derived
PubMed Identifier
30033644
Citation
Phanuphak N, Anand T, Jantarapakde J, Nitpolprasert C, Himmad K, Sungsing T, Trachunthong D, Phomthong S, Phoseeta P, Tongmuang S, Mingkwanrungruang P, Meekrua D, Sukthongsa S, Hongwiangchan S, Upanun N, Barisri J, Pankam T, Phanuphak P. What would you choose: Online or Offline or Mixed services? Feasibility of online HIV counselling and testing among Thai men who have sex with men and transgender women and factors associated with service uptake. J Int AIDS Soc. 2018 Jul;21 Suppl 5(Suppl Suppl 5):e25118. doi: 10.1002/jia2.25118.
Results Reference
derived

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Innovative Strategy to Offer Online Test and Treat for Thai MSM/TG

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