Structured Peer-delivered ART and Reentry Community Strategy
Structured Peer-delivered Antiretroviral Therapy (ART) and Reentry Community Strategy to Overcome Barriers to HIV Care Continuity During Community Re-entry From Incarceration in South Africa
Johns Hopkins University
400 participants
Nov 18, 2024
INTERVENTIONAL
Conditions
Summary
The overarching goal of this study is to implement a transition community adherence club strategy (Full-SPARCS) for HIV-positive individuals transitioning from correctional to community settings in South Africa. The investigators seek to provide actionable findings to inform policy decisions to contribute to HIV care continuity with this population. The investigators note that effectiveness and scalability often conflict with intervention design; thus, the investigators have proposed testing whether a group approach is effective and the investigators will assess the costs of each component * To compare the effectiveness of Full-SPARCS to care as usual to achieve HIV RNA suppression 6 months following correctional facility release * To assess determinants of implementation of Full-SPARCS * To assess the scalability through costing and cost effectiveness analysis of Full-SPARCS
Eligibility
Inclusion Criteria5
- Incarcerated at one of the participating study enrolment sites, awaiting trial (un-sentenced) and sentenced individuals.
- Diagnosed with HIV and ART at the time of enrolment.
- Anticipated release or trial date within three months of study enrolment.
- Self-report expected to reside in an unrestricted environment within Ekurhuleni, Tshwane, or Johannesburg districts of Gauteng Province and within proximity to one of the SPARCS intervention sites (i.e., within 20km, 45-minute travel time, or two local taxi minibus rides)
- Willing to participate in study post-release follow-up activities and provide contact information for post-release follow-up.
Exclusion Criteria6
- \<18 years of age.
- Condition (severe cognitive dysfunction or mental illness) rendering the individual unable to provide informed consent.
- Unable to provide informed consent to participate in the study.
- Assessment by DCS health staff indicating that the individual requires a high intensity of care exceeding that which can be provided in a differentiated model of care setting.
- Not released from the correctional facility during the period of intervention delivery.
- Release to a region outside of Gauteng.
Interventions
Within 14 days of release, participants will have one-on-one contact with a facilitator to update locator information, continue rapport building, review disclosure plans, provide a reminder of SPARCS logistics, and assign or remind the participant to a SPARCS group based on their location of residence and timing of release (depending on whether this occurred pre-release). Each Full-SPARCS meeting lasts approximately 2 hours, and the sessions occur in a private space in a community venue (e.g., community centre or church).
Locations(1)
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NCT06027671