Now Available for Public Comment: Notice of Proposed Rulemaking (NPRM) for FDAAA 801 and NIH Draft Reporting Policy for NIH-Funded Trials

Male Engagement in PMTCT Services

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborators:
Elizabeth Glaser Pediatric AIDS Foundation
Mbarara University of Science and Technology
Information provided by (Responsible Party):
FHI 360
ClinicalTrials.gov Identifier:
NCT01903889
First received: July 17, 2013
Last updated: May 19, 2014
Last verified: May 2014
  Purpose

The study employs a quasi-experimental design in 8 public health centers in southwest Uganda offering care and treatment (C&T) services. In 4 health centers, a basic intervention is introduced, whereby HIV/AIDS providers are trained on contraception for HIV-positive women. They are charged with counseling C&T clients on FP; offering condoms, pills and injectables; and referring clients for other FP methods. In the other 4 health centers, the basic intervention is introduced along with an intervention for constructive male engagement in HIV and FP services. This includes training of C&T providers on gender-based influences on health behaviors; provision of couples' HIV testing and FP counseling services; and community-based education for men to promote gender equitable norms and male participation in health services.


Condition Intervention
HIV
Other: clinic based intervention
Other: clinic and community based intervention

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Health Services Research
Official Title: Promoting Constructive Male Engagement to Increase Use of Prevention of Mother to Child Transmission (PMTCT) Services

Resource links provided by NLM:


Further study details as provided by FHI 360:

Primary Outcome Measures:
  • To assess the effectiveness of an intervention aimed at constructively engaging men in FP decision making [ Time Frame: 12 months ] [ Designated as safety issue: No ]
    Dual method use among couples with at least one partner using C&T services


Secondary Outcome Measures:
  • To measure changes over time in uptake of Prong 3 PMTCT services, comparing facilities that are and are not exposed to the constructive male engagement intervention [ Time Frame: 6 months ] [ Designated as safety issue: No ]
    Number of new ANC clients

  • To assess the effect of reinforcements introduced to enhance C&T providers' capacity to serve the FP needs of HIV-positive clients, as reflected in C&T clients' knowledge, attitudes, and behaviors related to FP. [ Time Frame: 12 months ] [ Designated as safety issue: No ]
    Dual method use among couples with at least one partner using C&T services 2) Knowledge and attitudes related to FP

  • To explore condom use dynamics and the factors favoring and discouraging consistent use by cohabiting couples [ Time Frame: 1 month ] [ Designated as safety issue: No ]
    1) Consistency of condom use 2) Factors encouraging and impeding consistent condom use

  • To evaluate men's knowledge and attitudes related to gender norms and FP and HIV services before and after participation in a 10-week community education and mobilization program. [ Time Frame: 10 months ] [ Designated as safety issue: No ]
    1) Perspectives on acceptable gender norms 2) Knowledge, attitudes, and behaviors related to use of family planning and HIV services.

  • To document the technical, human, and material resources required to implement the study interventions and to estimate the financial cost of implementation at scale. [ Time Frame: 12 months ] [ Designated as safety issue: No ]
    Cost of implementing HIV-FP integration intervention and male engagement intervention.


Enrollment: 3806
Study Start Date: January 2013
Estimated Study Completion Date: August 2014
Estimated Primary Completion Date: May 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Clinic based intervention
basic intervention is introduced, whereby HIV/AIDS providers are trained on contraception for HIV-positive women. They are charged with counseling C&T clients on FP; offering condoms, pills and injectables; and referring clients for other FP methods
Other: clinic based intervention
counseling C&T clients on FP; offering condoms, pills and injectables; and referring clients for other FP methods
Experimental: clinic and community based intervention
The basic intervention is introduced along with an intervention for constructive male engagement in HIV and FP services. This includes training of C&T providers on gender-based influences on health behaviors; provision of couples' HIV testing and FP counseling services; and community-based education for men to promote gender equitable norms and male participation in health services.
Other: clinic and community based intervention
basic intervention is introduced along with an intervention for constructive male engagement in HIV and FP services

Detailed Description:

This study will be conducted in Kabale District, Uganda, a rural district where prevention of mother to child transmission (PMTCT) and care and treatment (C&T) services are offered in eight public sector health facilities. The primary aim of this study is to test an intervention for increasing use of the full spectrum of PMTCT services, including family planning (FP), through enhanced constructive male involvement in reproductive health decision making. This aim will be accomplished by conducting a cluster randomized trial, whereby a "constructive male engagement" intervention package will be introduced in four randomly selected health centers and surrounding communities; the other four sites will serve as comparisons. Pre- and post-intervention cross sectional surveys will be conducted with male and female C&T clients to assess intervention effectiveness, measured in terms of dual method use. In addition to the male engagement intervention, reinforcements will be introduced in all eight participating facilities to enhance providers' capacity to serve the FP needs of C&T clients. We hypothesize that the percentage of clients reporting dual method use will increase slightly in all facilities as a result of this "HIV-FP integration intervention." To measure the independent effect of the reinforcements, the study will compare contraceptive knowledge, attitudes, and behaviors of clients measured pre- and post-intervention in the comparison sites only, in the absence of the male engagement intervention. We further hypothesize that improvements will be incrementally greater in the four facilities exposed to the additional constructive male engagement intervention.

The study will include additional data collection and analyses to support secondary objectives.

  1. Services statistics will be tracked to assess changes in uptake and continuation of PMTCT services.
  2. The study will include a qualitative component to investigate condom use behaviors. Based on other investigations, it is anticipated that rates of self-reported condom use among C&T clients will be high. To examine those behaviors more closely and to circumvent courtesy bias often associated with quantitative surveys, the study will conduct individual in-depth interviews with a subset of female and male C&T clients reporting consistent condom use.
  3. The constructive male engagement intervention will comprise both community- and clinic-based components. To assess the effectiveness of the community-based men's workshops, the study will assess changes in knowledge, attitudes, and behaviors among men exposed to the community-based intervention by surveying them before and 4 months after community-level training is held. Interviews will assess knowledge and attitudes related to FP and HIV services (PMTCT in particular), with particular focus on gender norms supporting constructive male involvement. Interviews will also examine clients' recollection of services and messages received in the health center, along with their direct and indirect exposure to the community-based men's workshops.
  4. The effectiveness of the intervention components aimed at reinforcing the capacity of clinic-based providers to serve the family planning needs of HIV-positive individuals and to engage male partners constructively in FP decision making will be assessed in terms of its impact on C&T clients. Specifically, interviews with C&T clients will include questions about messages communicated by providers and service delivery practices reflecting successful implementation of the intervention components.
  5. Finally, the study will examine the resource requirements for adding each the interventions (reinforcement of FP and male involvement) into C&T services. Based on costs of the piloted interventions, the study will arrive at an estimate of the cost of implementing these interventions at scale under the direction of the district management team.
  Eligibility

Ages Eligible for Study:   18 Years to 60 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

female participants

  • attending pre-ART and ART services;
  • non-pregnant women;
  • age 18 to 45;
  • sexually active with any type of partner within the past 3 months.

male participants

  • attending pre-ART and ART services;
  • age 18 to 60;
  • sexually active within the past 3 months with partner, either co-habiting partner or steady, with partner aged 18 to 45 and is not pregnant.

Exclusion Criteria:

  • For the post-intervention interviews, clients who initiated Care & Treatment services in one of the intervention facilities less than 3 months prior will be excluded given insufficient exposure to the intervention.
  • Clients unable to speak Runyankole, the dominant language in the region, will also be excluded
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01903889

Locations
Uganda
Bukinda Health Center
Kabale, Uganda
Kamkira Health Center
Kabale, Uganda
Kamwezi Health Center
Kabale, Uganda
Maziba Health Center
Kabale, Uganda
Mparo Health Center
Kabale, Uganda
Muko Health Center
Kabale, Uganda
Rubaya Health Center
Kabale, Uganda
Sponsors and Collaborators
FHI 360
Elizabeth Glaser Pediatric AIDS Foundation
Mbarara University of Science and Technology
Investigators
Principal Investigator: Theresa Hoke, Ph.D., MPH FHI 360
  More Information

No publications provided

Responsible Party: FHI 360
ClinicalTrials.gov Identifier: NCT01903889     History of Changes
Other Study ID Numbers: 10385
Study First Received: July 17, 2013
Last Updated: May 19, 2014
Health Authority: United States: PHSC IRB

Keywords provided by FHI 360:
AE adverse event
AIDS acquired immunodeficiency syndrome
ALT (SGPT) alanine aminotransferase
ART antiretroviral therapy
AST (SGOT) aspartate aminotransferase
DCF data collection forms
DMC Data Monitoring Committee
FDA (U.S.) Food and Drug Administration
GCP Good Clinical Practice guidelines
HB sAg Hepatitis B surface antigen
ICH International Conference of Harmonization
IND Investigational New Drug Application
IRB Institutional Review Board
IU International units
mg milligram(s)
mm3 cubic millimeter(s)
PCR polymerase chain reaction
SAE serious adverse event
µg microgram
ULN upper limit of the normal range
WB Western Blot
ANC Antenatal care
ART Antiretroviral therapy
ARV Antiretroviral
C&T Care and treatment
CPR Contraceptive prevalence rate
DHS Demographic and Health Survey
EGPAF Elizabeth Glaser Pediatric AIDS Foundation
FP Family planning
HIV Human immunodeficiency virus

ClinicalTrials.gov processed this record on November 24, 2014