Extended data for Stig2Health implementational study: Stigma-directed services to improve 'linkage to care' for people living with HIV in rural Tanzania

Magnolini, Raphael; Senkoro, Elizabeth; Kalinjuma, Aneth Vedastus; Kitau, Olivia; Kivuma, Bernard; Samson, Leila; Eichenberger, Anna; Mollel, Getrud Joseph; Krinke, Eileen; Okuma, James; Ndege, Robert; Glass, Tracy R.; Mapesi, Herry; Vanobberghen, Fiona; Battegay, Manuel; Weisser, Maja

doi:10.5281/zenodo.5916625

Cited by 2 publications

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“…Clearance for stigma interventions with updated consent and documentation were added to the KIULARCO protocol and approved by ethical committees within a respective amendment (IHI/IRB/AMM/No:08-2020 and IHI/IRB/AMM/No: 2-2021; NIMR/HQ/R.8c/Vol.I/764 and NIMR/HQ/R.8c/Vol.I/896). Patients will sign an informed consent form (see Extended data 44 ). Patients can either accept or reject stigma services.…”

Section: Protocolmentioning

confidence: 99%

“…Well-trained lay counselors openly living with HIV (one male, one female) will be responsible for the conduction of all stigma-related services. Lay counsellors will be trained by different medical professionals and professional counselors over a duration of 4 weeks using a standard operating procedure aligned to the national guidelines (competency list in Extended data , Table S2 44 ). The lay counselors will be selected from patients at our clinic and have either been living with HIV since birth or for multiple years.…”

Section: Protocolmentioning

confidence: 99%

“…We will use active learning techniques like role play, brainstorming, discussions with active listening 51 , storytelling and exercises with picture cards . Five sessions, comprising of a duration of 30-45min and maximum participant number of 10 patients per session, with different standardized content for group support therapy, including integration of HIV and ART in everyday life, internalized and community stigma, depression and coping as well as disclosure and relationship, have been elaborated upon (Table S1, Extended data 44 ). The positive effects of implementation of group support therapy and group health education 27 , 35 within similar settings has been described previously.…”

Section: Protocolmentioning

confidence: 99%

“…Assuming a pre-intervention cohort of 511 adults, a 10% increase in linkage (from 70 to 80%), a two-sided type I error rate of 5%, and 90% power, 321 adults are required for the post-intervention group. The full sample size calculation can be found in the Extended data 44 . Based on the enrolment into KIULARCO from 2017 of >500 patients, we expect to reach the required sample size within one year.…”

Section: Protocolmentioning

confidence: 99%

“…Zenodo: Extended data for Stig2Health implementational study: Stigma-directed services to improve 'linkage to care' for people living with HIV in rural Tanzania. https://doi.org/10.5281/zenodo.5916625 44 …”

Section: Data Availabilitymentioning

confidence: 99%

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Stigma-directed services (Stig2Health) to improve ‘linkage to care’ for people living with HIV in rural Tanzania: study protocol for a nested pre-post implementation study within the Kilombero and Ulanga Antiretroviral Cohort

Magnolini¹,

Senkoro²,

Kalinjuma³

et al. 2022

Open Res Africa

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Background: HIV-related stigma is a major barrier to the timely linkage and retention of patients in HIV care in sub-Saharan Africa, where most people living with HIV/AIDS reside. In this implementation study we aim to evaluate the effect of stigma-directed services on linkage to care and other health outcomes in newly diagnosed HIV-positive patients. Methods: In a nested project of the Kilombero and Ulanga Antiretroviral Cohort in rural Tanzania, we conduct a prospective observational pre-post study to assess the impact of a bundle of stigma-directed services for newly diagnosed HIV positive patients. Stigma-directed services, delivered by a lay person living with HIV, are i) post-test counseling, ii) post-test video-assisted teaching, iii) group support therapy and group health education, and iv) mobile health. Patients receiving stigma services (enrolled from 1st February 2020 to 31st August 2021) are compared to a historical control receiving the standard of care (enrolled from 1st July 2017 to 1st February 2019). The primary outcome is ‘linkage to care’. Secondary endpoints are retention in care, viral suppression, death and clinical failure at 6-12 months (up to 31st August 2022). Self-reported stigma and depression are assessed using the Berger Stigma scale and the PHQ-9 questionnaire, respectively. The sample size calculation was based on cohort data from 2018. Assuming a pre-intervention cohort of 511 newly diagnosed adults of whom 346 (68%) were in care and on antiretroviral treatment (ART) at 2 months, a 10% increase in linkage (from 70 to 80%), a two-sided type I error rate of 5%, and 90% power, 321 adults are required for the post-implementation group. Discussion: We expect that integration of stigma-directed services leads to an increase of proportions of patients in care and on ART. The findings will provide guidance on how to integrate stigma-directed services into routine care in rural sub-Saharan Africa.

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Section: Protocolmentioning

confidence: 99%

Section: Protocolmentioning

confidence: 99%