Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Consistent treatment with anti-retroviral therapy (ART) suppresses viral load (VL), prolonging life and improving quality of life for HIV+ persons. Suppressing VL benefits communities by reducing transmission to others. Mere availability of ART and care, however, is insufficient; the benefits of ART depend upon HIV+ persons' continuous visits to the health care provider, regular monitoring and regular delivery of medications, - known as retention in HIV care. In spite of national efforts, up to a quarter of HIV+ persons, especially low-income minorities are out of care. Innovative interventions are therefore urgently needed to maximize engagement and retention in HIV care, self-reported adherence, as well as HIV-1 RNA viral load suppression. In pursuit of these aims, the proposed study will assess outcomes of the following interventions in comparison to usual care: 1) contingency management (CM) only; 2) peer navigation (PN) only; and 3) a combined approach that integrates both CM and PN (CA) which the investigators hypothesize to be most effective in improving HIV clinical outcomes.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Contingency Management only | Active Comparator | Participants assigned to this arm will receive payments for attending regular HIV medical appointments at the clinic and filling prescribed HIV medications at the pharmacy |
|
| Peer Navigation only | Active Comparator | Participants in this arm will be assigned a peer navigator to assist them in accessing and remaining in HIV care |
|
| Combined Contingency Management and Peer Navigation | Experimental | Participants in this arm will be assigned a peer navigator to assist them in accessing and remaining in HIV care and will be eligible to receive incentives for attending HIV care visits/refilling prescriptions. |
|
| Usual care | No Intervention | Participants in this arm will receive the care that they would usually get in their clinic in the absence of this study. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Combined Contingency Management and Peer Navigation | Behavioral |
| ||
| Contingency Management |
| Measure | Description | Time Frame |
|---|---|---|
| Change in retention-in-care behaviors over 12 months | Using a 2x2 factorial design, to examine the effect of the three interventions -- peer navigation, contingency management, combined approach and usual care -- and evaluate how well they improve retention in HIV care | Basline, follow-ups at month 2, 6, 12 |
| Change in HIV RNA viral load suppression and medication adherence over 12 months | Using the same design, to examine the effects of the PN, CM and, CA interventions on HIV RNA viral load suppression and self-reported adherence | Basline, follow-ups at month 2, and 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Cost effectiveness | A secondary aim is to examine the cost-offset and potential cost-effectiveness of each intervention compared with usual care | 5 years |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not meeting any of the criteria identified above
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| William Cunningham, MD, MPH | University of California, Los Angeles | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Center for Health Justice | Los Angeles | California | 90012 | United States | ||
| Los Angeles Sheriff's Department |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Behavioral |
|
| Peer Navigation | Behavioral |
|
| Los Angeles |
| California |
| 90012 |
| United States |
| AltaMed Health Services Corporation | Los Angeles | California | 90022 | United States |
| Oasis Clinic | Los Angeles | California | 90059 | United States |
| Olive View Medical Center | Sylmar | California | 91342 | United States |
| Northeast Valley Health Corporation | Van Nuys | California | 91401 | United States |
| ID | Term |
|---|---|
| D000163 | Acquired Immunodeficiency Syndrome |
| ID | Term |
|---|---|
| D015658 | HIV Infections |
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D015229 | Sexually Transmitted Diseases, Viral |
| D012749 | Sexually Transmitted Diseases |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D012897 | Slow Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |
Not provided
Not provided