| Title: |
Effectiveness of integrating HIV prevention within sexual reproductive health services with or without peer support among adolescents and young adults in rural KwaZuluNatal, South Africa (Isisekelo Sempilo): 2 x 2 factorial, openlabel, randomised controlled trial |
| Authors: |
Shahmanesh, Maryam; Chimbindi, Natsayi; Busang, Jacob; Chidumwa, Glory; Mthiyani, Nondumiso; Herbst, Carina; Okesola, Nonhlanhla; Dreyer, Jaco; Zuma, Thembelihle; Luthuli, Manono; Gumede, Dumsani; Hlongwane, Siphesihle; Mdluli, Simphiwe; Msane, Sithembile; Smit, Theresa; Molina, Jean-Michel; Khoza, Thandeka; Behuhuma, Ngundu Osee; McGrath, Nuala; Seeley, Janet; Harling, Guy; Sherr, Lorraine; Copas, Andrew; Baisley, Kathy |
| Source: |
The Lancet HIV , 11 (7) e449-e460. (2024) |
| Publisher Information: |
ELSEVIER INC |
| Publication Year: |
2024 |
| Collection: |
University College London: UCL Discovery |
| Description: |
Background: Approximately 200 000 South Africans acquired HIV in 2021 despite the availability of universal HIV test and treat and pre-exposure prophylaxis (PrEP). The aim of this study was to test the effectiveness of sexual and reproductive health services or peer support, or both, on the uptake of serostatus neutral HIV services or reduction of sexually transmissible HIV. Methods: We did an open-label, 2 × 2 randomised factorial trial among young people in a mostly rural area of KwaZulu-Natal, South Africa. Inclusion criteria included being aged 16–29 years, living in the mapped geographical areas that were accessible to the area-based peer navigators, being willing and able to provide informed consent, and being willing to provide a dried blood spot for anonymous HIV testing and HIV viral load measurement at 12 months. Participants were randomly allocated by computer-generated algorithm to one of four groups: those in the standard-of-care group were referred to youth-friendly services for differentiated HIV prevention (condoms, universal HIV test and treat with antiretroviral therapy, and PrEP if eligible); those in the sexual and reproductive health services group received baseline self-collected specimens for sexually transmitted infection (STI) testing and referral to integrated sexual and reproductive health and HIV prevention services; those in the peer support group were referred to peer navigators for health promotion, condom provision, and facilitation of attendance for differentiated HIV prevention services; and those in the final group received a combination of sexual and reproductive health services and peer support. Coprimary outcomes were linkage to clinical services within 60 days of enrolment, proportion of participants who had sexually transmissible HIV at 12 months after enrolment, and proportion of sampled individuals who consented to participation and gave a dried blood spot for HIV testing at 12 months. Logistic regression was used for analyses, and adjusted for age, sex, and rural or ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10210199/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10210199/1/1-s2.0-S235230182400119X-main.pdf; https://discovery.ucl.ac.uk/id/eprint/10210199/ |
| Rights: |
open |
| Accession Number: |
edsbas.87A956CA |
| Database: |
BASE |