Key population-led community-based same-day antiretroviral therapy (CB-SDART) initiation hub in Bangkok, Thailand: a protocol for a hybrid type 3 implementation trial
Abstract Background Same-day antiretroviral therapy (SDART) initiation, in which people living with HIV (PLHIV) who are antiretroviral therapy (ART)-naïve, willing, and clinically eligible start ART on the same day of HIV diagnosis, has been implemented in several healthcare facilities in Thailand s...
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | Implementation Science Communications |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43058-022-00352-9 |
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| author | Sita Lujintanon Sorawit Amatavete Supanat Thitipatarakorn Thanyawee Puthanakit Wipaporn Natalie Songtaweesin Tanachai Chaisalee Surang Janyam Nittaya Phanuphak Reshmie A. Ramautarsing |
| author_facet | Sita Lujintanon Sorawit Amatavete Supanat Thitipatarakorn Thanyawee Puthanakit Wipaporn Natalie Songtaweesin Tanachai Chaisalee Surang Janyam Nittaya Phanuphak Reshmie A. Ramautarsing |
| author_sort | Sita Lujintanon |
| collection | DOAJ |
| description | Abstract Background Same-day antiretroviral therapy (SDART) initiation, in which people living with HIV (PLHIV) who are antiretroviral therapy (ART)-naïve, willing, and clinically eligible start ART on the same day of HIV diagnosis, has been implemented in several healthcare facilities in Thailand since 2017. This evidence-based practice has demonstrated increased ART uptake, virologic suppression, and retention in care. However, linkage to care gaps exist in community-based organizations (CBOs) in Bangkok whereby as much as 20% of key populations (KP), mainly men who have sex with men and transgender women, living with HIV were lost to follow-up pre-ART initiation. To increase access to and uptake of ART among these populations, this study proposes that trained KP lay providers should lead community-based ART (CB-SDART) initiation service. This protocol describes the combined use of the Proctor’s implementation outcome framework and the Consolidated Framework for Implementation Research to guide and evaluate the CB-SDART implementation. Methods This study follows the hybrid design type 3: it is an implementation trial that secondarily assesses service and client outcomes by comparative interrupted time series analysis. Five strategies have been formulated to meet three implementation outcomes (i.e., feasibility, fidelity, and sustainability): (1) developing stakeholder relationships by engaging the CBO leaderships, (2) training and educating KP lay providers, (3) adapting and tailoring SDART to CBO-specific context, (4) using evaluative and iterative strategies to assess adherence to standard operating procedures, and (5) developing stakeholder relationships by engaging external stakeholders. Teleconsultation with physicians and ART home delivery will be integrated as another ART initiation option for clients and allow service provision during the COVID-19 pandemic. A mixed-method assessment will be conducted on key stakeholders and PLHIV diagnosed at two implementing CBOs, Rainbow Sky Association of Thailand and Service Workers in Group Foundation, in Bangkok, Thailand. Discussion This implementation research may be the first to provide robust data at the implementation, service, and client levels to inform how to successfully task-shift SDART initiation service to trained KP lay providers and facilitate the expansion of CB-SDART in the future. Trial registration This trial was registered with the Thai Clinical Trial Registry as TCTR20210709004 on July 9, 2021. |
| first_indexed | 2024-04-12T16:54:07Z |
| format | Article |
| id | doaj.art-c28b6f79735840b796ffab2754166702 |
| institution | Directory Open Access Journal |
| issn | 2662-2211 |
| language | English |
| last_indexed | 2024-04-12T16:54:07Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj.art-c28b6f79735840b796ffab27541667022022-12-22T03:24:18ZengBMCImplementation Science Communications2662-22112022-10-013111310.1186/s43058-022-00352-9Key population-led community-based same-day antiretroviral therapy (CB-SDART) initiation hub in Bangkok, Thailand: a protocol for a hybrid type 3 implementation trialSita Lujintanon0Sorawit Amatavete1Supanat Thitipatarakorn2Thanyawee Puthanakit3Wipaporn Natalie Songtaweesin4Tanachai Chaisalee5Surang Janyam6Nittaya Phanuphak7Reshmie A. Ramautarsing8Department of Epidemiology, Johns Hopkins Bloomberg School of Public HealthInstitute of HIV Research and Innovation (IHRI)Institute of HIV Research and Innovation (IHRI)Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University (PIDCU)Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University (PIDCU)Rainbow Sky Association of Thailand (RSAT)Service Workers In Group Foundation (SWING)Institute of HIV Research and Innovation (IHRI)Institute of HIV Research and Innovation (IHRI)Abstract Background Same-day antiretroviral therapy (SDART) initiation, in which people living with HIV (PLHIV) who are antiretroviral therapy (ART)-naïve, willing, and clinically eligible start ART on the same day of HIV diagnosis, has been implemented in several healthcare facilities in Thailand since 2017. This evidence-based practice has demonstrated increased ART uptake, virologic suppression, and retention in care. However, linkage to care gaps exist in community-based organizations (CBOs) in Bangkok whereby as much as 20% of key populations (KP), mainly men who have sex with men and transgender women, living with HIV were lost to follow-up pre-ART initiation. To increase access to and uptake of ART among these populations, this study proposes that trained KP lay providers should lead community-based ART (CB-SDART) initiation service. This protocol describes the combined use of the Proctor’s implementation outcome framework and the Consolidated Framework for Implementation Research to guide and evaluate the CB-SDART implementation. Methods This study follows the hybrid design type 3: it is an implementation trial that secondarily assesses service and client outcomes by comparative interrupted time series analysis. Five strategies have been formulated to meet three implementation outcomes (i.e., feasibility, fidelity, and sustainability): (1) developing stakeholder relationships by engaging the CBO leaderships, (2) training and educating KP lay providers, (3) adapting and tailoring SDART to CBO-specific context, (4) using evaluative and iterative strategies to assess adherence to standard operating procedures, and (5) developing stakeholder relationships by engaging external stakeholders. Teleconsultation with physicians and ART home delivery will be integrated as another ART initiation option for clients and allow service provision during the COVID-19 pandemic. A mixed-method assessment will be conducted on key stakeholders and PLHIV diagnosed at two implementing CBOs, Rainbow Sky Association of Thailand and Service Workers in Group Foundation, in Bangkok, Thailand. Discussion This implementation research may be the first to provide robust data at the implementation, service, and client levels to inform how to successfully task-shift SDART initiation service to trained KP lay providers and facilitate the expansion of CB-SDART in the future. Trial registration This trial was registered with the Thai Clinical Trial Registry as TCTR20210709004 on July 9, 2021.https://doi.org/10.1186/s43058-022-00352-9HIVAntiretroviral therapy initiationCommunity-based serviceMen who have sex with menTransgender womenKey population |
| spellingShingle | Sita Lujintanon Sorawit Amatavete Supanat Thitipatarakorn Thanyawee Puthanakit Wipaporn Natalie Songtaweesin Tanachai Chaisalee Surang Janyam Nittaya Phanuphak Reshmie A. Ramautarsing Key population-led community-based same-day antiretroviral therapy (CB-SDART) initiation hub in Bangkok, Thailand: a protocol for a hybrid type 3 implementation trial Implementation Science Communications HIV Antiretroviral therapy initiation Community-based service Men who have sex with men Transgender women Key population |
| title | Key population-led community-based same-day antiretroviral therapy (CB-SDART) initiation hub in Bangkok, Thailand: a protocol for a hybrid type 3 implementation trial |
| title_full | Key population-led community-based same-day antiretroviral therapy (CB-SDART) initiation hub in Bangkok, Thailand: a protocol for a hybrid type 3 implementation trial |
| title_fullStr | Key population-led community-based same-day antiretroviral therapy (CB-SDART) initiation hub in Bangkok, Thailand: a protocol for a hybrid type 3 implementation trial |
| title_full_unstemmed | Key population-led community-based same-day antiretroviral therapy (CB-SDART) initiation hub in Bangkok, Thailand: a protocol for a hybrid type 3 implementation trial |
| title_short | Key population-led community-based same-day antiretroviral therapy (CB-SDART) initiation hub in Bangkok, Thailand: a protocol for a hybrid type 3 implementation trial |
| title_sort | key population led community based same day antiretroviral therapy cb sdart initiation hub in bangkok thailand a protocol for a hybrid type 3 implementation trial |
| topic | HIV Antiretroviral therapy initiation Community-based service Men who have sex with men Transgender women Key population |
| url | https://doi.org/10.1186/s43058-022-00352-9 |
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