Dataset Information

Exploration of Implementation Patterns and Content from a Text-Based Outreach Intervention Clinical Trial for Newly Diagnosed, HIV-Positive MSM in Beijing, China.

ABSTRACT: The Multi-component HIV Intervention Packages for Chinese MSM (China MP3) project sought to facilitate engagement in care and initiation of antiretroviral therapy among newly HIV-diagnosed men who have sex with men in Beijing, China through the implementation of in-person peer-counseling (PC) and a weekly short message service (SMS)-based outreach text with as-needed follow-up during the first 12-months of living with HIV. Implementation of the interactive text-based intervention used a 'ticket system' to monitor and document responses to texted check-ins and PC follow-up. Using this tracking system, we characterized the 1521 tickets generated during the China-MP3 intervention across 184 intervention participants. A wide variety of topics were the focus of interactions prompted by texted outreach although most appeared to focus on issues related to ART and CD4 and viral load. Almost all participants engaged in at least one SMS-related discussion. Sending regular check-ins may offer unique opportunities to newly diagnosed MSM to ask questions or gather support between face-to-face visits.

SUBMITTER: Knudson A

PROVIDER: S-EPMC6566097 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Exploration of Implementation Patterns and Content from a Text-Based Outreach Intervention Clinical Trial for Newly Diagnosed, HIV-Positive MSM in Beijing, China.

Knudson Angela A Shaw Sarah S Yin Lu L Xiao Dong D Qian Han-Zhu HZ Sullivan Stephen S Liu Hongjie H Ruan Yuhua Y Shao Yiming Y Vermund Sten H SH Amico K Rivet KR

AIDS and behavior 20190501 5

The Multi-component HIV Intervention Packages for Chinese MSM (China MP3) project sought to facilitate engagement in care and initiation of antiretroviral therapy among newly HIV-diagnosed men who have sex with men in Beijing, China through the implementation of in-person peer-counseling (PC) and a weekly short message service (SMS)-based outreach text with as-needed follow-up during the first 12-months of living with HIV. Implementation of the interactive text-based intervention used a 'ticket ...[more]

PMID: 30288683

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Project description:OBJECTIVE:Linkage to care is the bridge between HIV testing and HIV treatment, care and support. In Tanzania, mobile testing aims to address historically low testing rates. Linkage to care was reported at 14% in 2009 and 28% in 2014. The study compares linkage to care of HIV-positive individuals tested at mobile/outreach versus public health facility-based services within the first 6?months of HIV diagnosis. SETTING:Rural communities in four districts of Mbeya Region, Tanzania. PARTICIPANTS:A total of 1012 newly diagnosed HIV-positive adults from 16 testing facilities were enrolled into a two-armed cohort and followed for 6?months between August 2014 and July 2015. 840 (83%) participants completed the study. MAIN OUTCOME MEASURES:We compared the ratios and time variance in linkage to care using the Kaplan-Meier estimator and Log rank tests. Cox proportional hazards regression models to evaluate factors associated with time variance in linkage. RESULTS:At the end of 6?months, 78% of all respondents had linked into care, with differences across testing models. 84% (CI 81% to 87%, n=512) of individuals tested at facility-based site were linked to care compared to 69% (CI 65% to 74%, n=281) of individuals tested at mobile/outreach. The median time to linkage was 1?day (IQR: 1-7.5) for facility-based site and 6?days (IQR: 3-11) for mobile/outreach sites. Participants tested at facility-based site were 78% more likely to link than those tested at mobile/outreach when other variables were controlled (AHR=1.78; 95% CI 1.52 to 2.07). HIV status disclosure to family/relatives was significantly associated with linkage to care (AHR=2.64; 95% CI 2.05 to 3.39). CONCLUSIONS:Linkage to care after testing HIV positive in rural Tanzania has increased markedly since 2014, across testing models. Individuals tested at facility-based sites linked in significantly higher proportion and modestly sooner than mobile/outreach tested individuals. Mobile/outreach testing models bring HIV testing services closer to people. Strategies to improve linkage from mobile/outreach models are needed.

Project description:BACKGROUND:Newly diagnosed HIV-positive individuals are 35 to 100-fold more susceptible to Streptococcus pneumoniae infection compared to non-infected individuals. Therefore, the 23-valent pneumococcal polysaccharide vaccine (PPV23) has previously been recommended, though efficacy and effectiveness of vaccination remains controversial. Early severe B cell dysfunction is a central feature of HIV infection. The specific nature of the immune cells involved in the production of protective antigen-specific antibodies in HIV-positive individuals remains to be elucidated. OBJECTIVES:Evaluate the antibody and antigen-specific B cell response to the 23-valent pneumococcal polysaccharide vaccine in newly diagnosed HIV-positive patients. Moreover, determine if newly diagnosed patients with CD4<200 cells/?l benefit from 6-12 months of HAART, allowing partial viral suppression and immune reconstitution, prior to immunization. METHODS:Newly diagnosed HIV-positive patients with CD4>200 cells/?l and CD4<200 cells/?l were immunized with PPV23. Patients with CD4<200 cells/?l received either immediate or delayed immunization following 6-12 months of HAART. Antibody responses, opsonophagocytic activity and phenotypic analysis of pneumococcal polysaccharide-specific B cells were studied. RESULTS:Newly diagnosed HIV-positive patients demonstrated CD4-dependent increases in antibody and opsonophagocytic titers thought to be commensurate with protection. Functional opsonophagocytic titers of patients with CD4<200 cells/?l immunized immediately compared to patients with CD4<200 cells/?l receiving HAART for 6-12 months were not significantly different. Pneumococcal polysaccharide-specific B cells were distributed evenly between IgM memory and switched memory B cells for all groups, but IgM memory B cells were significantly lower than in HIV-negative individuals. CONCLUSIONS:Despite CD4-dependent pneumococcal polysaccharide-specific deficiencies in newly diagnosed HIV-positive patients, vaccination was beneficial based on opsonophagocytic titers for all newly diagnosed HIV-positive groups. In HIV-positive patients with CD4<200 cells/?l, 6-12 months of HAART did not improve opsonophagocytic titers or antibody concentrations. Based on these findings, immunization with the 23-valent pneumococcal polysaccharide vaccine should not be delayed in newly diagnosed HIV-positive patients with CD4<200 cells/?l.

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Project description:IntroductionCancer-related cognitive impairment (CRCI) is a distressing and disabling side-effect of cancer treatments affecting up to 75% of patients. For some patients, their cognitive impairment may be transient, but for a subgroup, these symptoms can be long-standing and have a major impact on the quality of life. This paper describes the protocol for a study: (1) to assess the feasibility of collecting longitudinal data on cognition via self-report, neuropsychological testing, peripheral markers of inflammation and neuroimaging and (2) to explore and describe patterns of cancer-related cognitive impairment over the course of treatment and recovery in patients with newly diagnosed, aggressive lymphoma undergoing standard therapy with curative intent.Methods and analysisThis is a prospective, longitudinal, feasibility study in which 30 newly diagnosed, treatment-naive patients with aggressive lymphoma will be recruited over a 12-month period. Patients will complete comprehensive assessments at three time points: baseline (time 1, pre-treatment) and two post-baseline follow-up assessments (time 2, mid-treatment and time 3, 6-8 weeks post-treatment completion). All patients will be assessed for self-reported cognitive difficulties and objective cognitive function using Stroop Colour and Word, Trail Making Test Part A and B, Hopkins Verbal Learning Test-Revised, Controlled Oral Word Association and Digit Span. Blood cell-based inflammatory markers and neuroimaging including a positron emission tomography (PET) with 18F-labelled fluoro-2-deoxyglucose (18F-FDG) and CT (18F-FDG-PET/CT) and a MRI will explore potential inflammatory and neuroanatomical or functional mechanisms and biomarkers related to CRCI. The primary intent of analysis will be to assess the feasibility of collecting longitudinal data on cognition using subjective reports and objective tasks from patients during treatment and recovery for lymphoma. These data will inform the design of a larger-scale investigation into the patterns of cognitive change over the course of treatment and recovery, adding to an underexplored area of cancer survivorship research.Ethics and disseminationEthical approval has been granted by Austin Health Human Rights Ethics Committee (HREC) in Victoria Australia. Peer reviewed publications and conference presentations will report the findings of this novel study.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12619001649101).

Dataset Information

Exploration of Implementation Patterns and Content from a Text-Based Outreach Intervention Clinical Trial for Newly Diagnosed, HIV-Positive MSM in Beijing, China.

Publications

Exploration of Implementation Patterns and Content from a Text-Based Outreach Intervention Clinical Trial for Newly Diagnosed, HIV-Positive MSM in Beijing, China.

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