Conditional economic incentives and motivational interviewing to improve adolescents’ retention in HIV care and adherence to antiretroviral therapy in Southeast Nigeria: study protocol for a cluster randomised trial
Abstract Background Adolescent HIV patients face enormous difficulty in accessing HIV care services. Given their vulnerability to risk-taking behaviour, this group also have worse treatment outcomes compared to other age groups. Poor treatment outcomes will impact negatively on HIV/AIDS management a...
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | Trials |
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| Online Access: | http://link.springer.com/article/10.1186/s13063-018-3095-4 |
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| author | Obinna Ikechukwu Ekwunife Maureen Ugonwa Anetoh Stephen Okorafor Kalu Prince Udegbulam Ele George Uchenna Eleje |
| author_facet | Obinna Ikechukwu Ekwunife Maureen Ugonwa Anetoh Stephen Okorafor Kalu Prince Udegbulam Ele George Uchenna Eleje |
| author_sort | Obinna Ikechukwu Ekwunife |
| collection | DOAJ |
| description | Abstract Background Adolescent HIV patients face enormous difficulty in accessing HIV care services. Given their vulnerability to risk-taking behaviour, this group also have worse treatment outcomes compared to other age groups. Poor treatment outcomes will impact negatively on HIV/AIDS management and control particularly in sub-Saharan Africa (SSA) as more than eight out of ten of the world’s HIV-infected adolescents live in this region of the world. Limited evidence exists on the effectiveness of service delivery interventions to support adolescents’ retention on antiretroviral therapy (ART) and adherence to ART. This trial is designed to evaluate the impact of conditional economic incentive and motivational interviewing on adolescents’ retention in HIV care and adherence to ART in Anambra State, Southeast Nigeria. Methods/design The study will be a cluster randomised controlled trial that will be conducted in selected HIV treatment hospitals in Anambra State, Nigeria. Based on sample size calculation, 12 HIV treatment hospitals from Anambra will be selected for the study. Six HIV treatment hospitals each will be randomised to either the intervention or the control arm. A structured adherence support scheme termed the ‘Incentive Scheme’ will be applied to the intervention arm while the control arm will receive routine HIV care (usual care). Additionally, patients in the intervention arm will receive motivational interviewing at baseline and following initiation of antiretroviral therapy (ART), they will receive a gift voucher of US$5.6 when HIV viral load (VL) is < 20 copies/mL at 12 weeks, a gift voucher of US$2.8 if the VL remains suppressed for the next 3 months, and the next 6 months, and finally a gift voucher of US$5.6 if the VL remains < 20 copies/mL at 1 year. All gift vouchers will be conditional not only on VL results but attending the motivational interviews. The primary outcome for the trial will be the difference between groups in the proportion with HIV VL suppression (≤ 20 copies/mL) by 12 months and then 24 months after withdrawal of incentive. Discussion The findings of this proposed trial will provide evidence on the feasibility of applying conditional economic incentives combined with motivational interviewing to improve retention and adherence to antiretroviral therapy of adolescents living with HIV in Nigeria and possibly in other sub-Saharan African countries. Trial registration Registered in the Pan African Clinical Trials Registry, ID: PACTR201806003040425. Registered on 2 February 2018. |
| first_indexed | 2024-12-11T08:39:13Z |
| format | Article |
| id | doaj.art-5b78ebed675740448e6a95d380af2eec |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-12-11T08:39:13Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-5b78ebed675740448e6a95d380af2eec2022-12-22T01:14:17ZengBMCTrials1745-62152018-12-011911910.1186/s13063-018-3095-4Conditional economic incentives and motivational interviewing to improve adolescents’ retention in HIV care and adherence to antiretroviral therapy in Southeast Nigeria: study protocol for a cluster randomised trialObinna Ikechukwu Ekwunife0Maureen Ugonwa Anetoh1Stephen Okorafor Kalu2Prince Udegbulam Ele3George Uchenna Eleje4Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe UniversityDepartment of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe UniversityVirology Laboratory, Nnamdi Azikiwe University Teaching HospitalDivision of Respiratory Medicine, Department of Medicine, Nnamdi Azikiwe University Teaching HospitalDepartment of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching HospitalAbstract Background Adolescent HIV patients face enormous difficulty in accessing HIV care services. Given their vulnerability to risk-taking behaviour, this group also have worse treatment outcomes compared to other age groups. Poor treatment outcomes will impact negatively on HIV/AIDS management and control particularly in sub-Saharan Africa (SSA) as more than eight out of ten of the world’s HIV-infected adolescents live in this region of the world. Limited evidence exists on the effectiveness of service delivery interventions to support adolescents’ retention on antiretroviral therapy (ART) and adherence to ART. This trial is designed to evaluate the impact of conditional economic incentive and motivational interviewing on adolescents’ retention in HIV care and adherence to ART in Anambra State, Southeast Nigeria. Methods/design The study will be a cluster randomised controlled trial that will be conducted in selected HIV treatment hospitals in Anambra State, Nigeria. Based on sample size calculation, 12 HIV treatment hospitals from Anambra will be selected for the study. Six HIV treatment hospitals each will be randomised to either the intervention or the control arm. A structured adherence support scheme termed the ‘Incentive Scheme’ will be applied to the intervention arm while the control arm will receive routine HIV care (usual care). Additionally, patients in the intervention arm will receive motivational interviewing at baseline and following initiation of antiretroviral therapy (ART), they will receive a gift voucher of US$5.6 when HIV viral load (VL) is < 20 copies/mL at 12 weeks, a gift voucher of US$2.8 if the VL remains suppressed for the next 3 months, and the next 6 months, and finally a gift voucher of US$5.6 if the VL remains < 20 copies/mL at 1 year. All gift vouchers will be conditional not only on VL results but attending the motivational interviews. The primary outcome for the trial will be the difference between groups in the proportion with HIV VL suppression (≤ 20 copies/mL) by 12 months and then 24 months after withdrawal of incentive. Discussion The findings of this proposed trial will provide evidence on the feasibility of applying conditional economic incentives combined with motivational interviewing to improve retention and adherence to antiretroviral therapy of adolescents living with HIV in Nigeria and possibly in other sub-Saharan African countries. Trial registration Registered in the Pan African Clinical Trials Registry, ID: PACTR201806003040425. Registered on 2 February 2018.http://link.springer.com/article/10.1186/s13063-018-3095-4HIVAIDSAdherenceMotivational interviewingAdolescentOperational research |
| spellingShingle | Obinna Ikechukwu Ekwunife Maureen Ugonwa Anetoh Stephen Okorafor Kalu Prince Udegbulam Ele George Uchenna Eleje Conditional economic incentives and motivational interviewing to improve adolescents’ retention in HIV care and adherence to antiretroviral therapy in Southeast Nigeria: study protocol for a cluster randomised trial Trials HIV AIDS Adherence Motivational interviewing Adolescent Operational research |
| title | Conditional economic incentives and motivational interviewing to improve adolescents’ retention in HIV care and adherence to antiretroviral therapy in Southeast Nigeria: study protocol for a cluster randomised trial |
| title_full | Conditional economic incentives and motivational interviewing to improve adolescents’ retention in HIV care and adherence to antiretroviral therapy in Southeast Nigeria: study protocol for a cluster randomised trial |
| title_fullStr | Conditional economic incentives and motivational interviewing to improve adolescents’ retention in HIV care and adherence to antiretroviral therapy in Southeast Nigeria: study protocol for a cluster randomised trial |
| title_full_unstemmed | Conditional economic incentives and motivational interviewing to improve adolescents’ retention in HIV care and adherence to antiretroviral therapy in Southeast Nigeria: study protocol for a cluster randomised trial |
| title_short | Conditional economic incentives and motivational interviewing to improve adolescents’ retention in HIV care and adherence to antiretroviral therapy in Southeast Nigeria: study protocol for a cluster randomised trial |
| title_sort | conditional economic incentives and motivational interviewing to improve adolescents retention in hiv care and adherence to antiretroviral therapy in southeast nigeria study protocol for a cluster randomised trial |
| topic | HIV AIDS Adherence Motivational interviewing Adolescent Operational research |
| url | http://link.springer.com/article/10.1186/s13063-018-3095-4 |
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