Please select the eligibility criteria that correspond to the clinical trial below.
Title: HIV Prevention for People Living With HIV/AIDS: Evaluation of an Intervention Toolkit for HIV Care and Treatment Settings
Brief Summary: The rapid scale-up of HIV care and treatment in resource-limited settings provides the opportunity to reach many HIV-positive individuals with prevention messages and interventions in care and treatment settings. However, HIV prevention is rarely incorporated into the routine care and treatment of people living with HIV, leaving missed opportunities to reach patients with critical interventions.

This study will evaluate an HIV prevention intervention package for health care settings in sub-Saharan Africa. The HIV prevention intervention will be delivered to HIV-seropositive patients in HIV care and treatment clinics during all routine visits. Health care providers (HCPs) will deliver HIV prevention messages on correct and consistent condom use, disclosure of serostatus, partner HIV testing, adherence and alcohol reduction. They will also assess and treat sexually transmitted infections (STIs) and provide basic contraceptives and safer pregnancy counseling.

Trained lay counselors (LCs) will deliver HIV prevention interventions in the clinics. LCs will be persons without medical training, many of whom will be PLHIV, who will be trained to provide HIV prevention counseling, promote HIV testing of partners and children (and provide HIV testing where allowed by national guidelines), and counsel HIV-positive patients on medication adherence and alcohol use.

The prevention intervention package will be evaluated in HIV clinics in three sub-Saharan African countries: Kenya, Namibia, and Tanzania. This project will be a longitudinal group-randomized trial with 9 intervention clinics (3 per country) and 9 comparison clinics (3 per country). Two hundred patients per clinic (total N = 3600) will be followed for 12 months. This evaluation will examine the effectiveness of the HIV prevention interventions delivered by HCPs and LCs on patient-level outcomes such as risky sexual behavior, disclosure of HIV status, partner HIV testing, alcohol use, HIV antiretroviral (ARV) medication adherence, STI treatment, pregnancies, and contraceptive use.

In addition to the patient outcomes, the acceptability of the interventions and materials, as well as the feasibility of integrating the interventions into HIV care and treatment settings, will be assessed.

Data will be collected via patient interviews, HCP and LC questionnaires, observations of HCP and LC patient visits, patient medical chart review, and review of clinic service data.


Options:
A: Inclusion Criteria:

* At least 18 years old
* HIV-positive patients receiving care at a project clinic and seen at the clinic at least twice prior to enrollment
* Sexually active within the past three months
* Planning to attend the clinic for at least 1 year
* Able to conduct interview in one of the following languages:

Kenya: English, Kiswahili Namibia: English, Oshiwambo, Damara-nama, Otjiherero, Afrikaans Tanzania: English, Kiswahili

* Able to provide informed consent to participate in the project

Exclusion Criteria:

* Younger than 18 years of age
* Not sexually active within the last three months
* Planning to move from the vicinity of the clinic within one year
* Not enrolled in the HIV clinic and/or have not been seen for at least two clinic visits
* Cannot provide informed consent
* Patients who are acutely ill or are determined by clinical staff to be too ill to participate
* Spouses or identified partners of participating patients
* Pregnant women and male partners of pregnant women, as family planning counseling and unintended pregnancy are some of the primary study outcomes
* Not able to complete interview in one of the languages in the inclusion criteria
* Participated in pilot study
B: Primary study participants for intervention evaluation are rural young men (n=1500) and their wives (n=1500). Inclusion and exclusion criteria for these men are as follows:

INCLUSION CRITERIA

* Age 18-30 years and Fluent in Marathi
* Willing to Have Wife Included in the Study
* Residing in the village for the past 2 years and residing with wife in village for past 3 months

EXCLUSION CRITERIA

* Sterile or Wife is Sterile
* Cognitive Impairment (husband or wife)
* Intend to move in next 18 months
C: Inclusion Criteria:

* Mexican American,
* 14 - 45 years old,
* English Speaking,
* non-viral sexually transmitted infection

Exclusion Criteria:

* Non-English speaking,
* viral sexually transmitted infection
D: Inclusion Criteria:

1. Aged 15-29 years
2. Presenting for elective termination of an unintended pregnancy
3. Has not had contraceptive counseling from the team.
4. Willing and able to understand and comply with study protocol
5. Willing and able to sign an informed consent in English

Exclusion Criteria:

1. Current pregnancy intended
2. Current pregnancy desired
3. Reason for pregnancy termination not elective (e.g. fetal anomalies, pregnancy resulted from rape or incest)
4. Plans pregnancy within 6 months
5. Has been administered any sedatives or cervical ripening agents
6. For minors, must not be a ward of the state.

Answer: A