Clinical trial NCT04953858: SNS to Increase HIV Testing Uptake and Linkage to Double Cascade Services Among Adolescent MSM and TGW in Thailand
Official title: Social Network Strategy to Promote HIV Testing and Linkage to HIV Services Among Young Men Who Have Sex With Men and Transgender Women in Thailand
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Social Network Strategy
HIV Self Testing
Men Who Have Sex With Men
Lead sponsor: Chulalongkorn University
Sponsor class: OTHER
First posted: 2021-07-08
Enrollment: 202
Sex: MALE
Minimum age (years): 15
Maximum age (years): 24
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: Potential recruiters will be approached in routine adolescent HIV treatment and services and those enrolled will approach peers to become network members who then come in for HIV testing
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: UNAIDS aims to end AIDS by 2030 using "90-90-90" diagnosis-treatment-viral suppression targets. Thailand has achieved elimination of HIV mother-to-child transmission, but continues to see new infections among adolescent men who have sex with men (YMSM) and transgender women (YTGW). Reaching and engagement of key populations to HIV services remains a major challenge, with differentiated care needed to address this. Investigators propose a study on outreach for HIV at-risk adolescents using peer-led social network strategies (SNS), linkage to facility-based HIV self-testing, and same day HIV prevention or treatment. The study will focus on the 15-19 year age group who have the highest HIV incidence in Thailand (6.9-10 per 100 person years, PY), but will also include young adults aged 20- 24 years of age, due to their frequently intertwining sex networks and very similar HIV incidence of 4.9-7.2 per 100 PY.

Eight hundred adolescent and young adult (AYA) MSM and TGW aged between 15-24 years will be recruited into a double HIV cascade care system. AYA aged between 15-24 years will be trained as recruiters to approach and refer their peers, 'network members' (NMs) to our adolescent clinic. NMs will be offered a choice of either blood-based or oral fluid-based HIV self-testing. HIV positive cases will be offered same-day antiretroviral therapy (SDART) and high-risk adolescents will be offered same day preexposure prophylaxis (PrEP). The project will be conducted at adolescent differentiated care services previously established by CIPHER grants in Thailand, located at King Chulalongkorn Memorial Hospital (KCMH), Bangkok. It will inform both Thailand and other Asia-Pacific region countries with similar epidemic patterns through an implementation research lens on strategies to engage YMSM and YTGW into HIV services, which investigators believe will make high-impact contributions to our collective ultimate goal of ending AIDS.


Eligibility criteria: Recruiters

Inclusion Criteria:

* ages 15-24 years
* assigned male gender at birth
* self-defined gender identity of either MSM or TGW
* any one of the following: living with HIV, using HIV pre-exposure prophylaxis, receiving intermittent HIV testing for ongoing HIV risk
* good rapport with King Chulalongkorn Memorial Hospital (KCMH) Adolescent Health Clinic, knowledgable on HIV and comfortable discussing HIV with peers

Network Members

Inclusion Criteria:

* ages 15-24 years
* assigned male gender at birth
* self-defined gender identity of either MSM or TGW
* self-reported oral and/or anal sex with a man in the past 12 months and at risk of HIV infection (multiple sex partners in the preceding 6 months and/or inconsistent condom use)
* no history of HIV testing or last HIV test \> 3 months prior to study entry

Exclusion Criteria:

* Known to be living with HIV

Primary outcomes:
measure: The effectiveness of using social network strategies to increase HIV testing uptake in YMSM and YTGW.
timeFrame: 24 months
Secondary outcomes:
measure: Pre-exposure prophylaxis (PrEP) uptake among HIV negative at-risk adolescents
timeFrame: 24 months
measure: Viral suppression at 6 months for those initiated on antiretroviral treatment among newly diagnosed HIV positive adolescents
timeFrame: 24 months
Other outcomes:
Locations:
city: Bangkok
country: Thailand
facility: The Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University
Study officials:
References: