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Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Care | Study protocol

Home-based intervention to test and start (HITS) protocol: a cluster-randomized controlled trial to reduce HIV-related mortality in men and HIV incidence in women through increased coverage of HIV treatment

Authors: T. Mathenjwa, H.-Y. Kim, T. Zuma, M. Shahmanesh, J. Seeley, P. Matthews, S. Wyke, N. McGrath, B. Sartorius, H. M. Yapa, O. Adeagbo, A. Blandford, A. Dobra, T. Bäernighausen, F. Tanser

Published in: BMC Public Health | Issue 1/2019

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Abstract

Background

To realize the full benefits of treatment as prevention in many hyperendemic African contexts, there is an urgent need to increase uptake of HIV testing and HIV treatment among men to reduce the rate of HIV transmission to (particularly young) women. This trial aims to evaluate the effect of two interventions - micro-incentives and a tablet-based male-targeted HIV decision support application - on increasing home-based HIV testing and linkage to HIV care among men with the ultimate aim of reducing HIV-related mortality in men and HIV incidence in young women.

Methods/design

This is a cluster randomized trial of 45 communities (clusters) in a rural area in the uMkhanyakude district of KwaZulu Natal, South Africa (2018–2021). The study is built upon the Africa Health Research Institute (AHRI)‘s HIV testing platform, which offers annual home-based rapid HIV testing to individuals aged 15 years and above. In a 2 × 2 factorial design, individuals aged ≥15 years living in the 45 clusters are randomly assigned to one of four arms: i) a financial micro-incentive (food voucher) (n = 8); ii) male-targeted HIV specific decision support (EPIC-HIV) (n = 8); iii) both the micro incentives and male-targeted decision support (n = 8); and iv) standard of care (n = 21). The EPIC-HIV application is developed and delivered via a tablet to encourage HIV testing and linkage to care among men. A mixed method approach is adopted to supplement the randomized control trial and meet the study aims.

Discussion

The findings of this trial will provide evidence on the feasibility and causal impact of two interventions - micro-incentives and a male-targeted HIV specific decision support - on uptake of home-based HIV testing, linkage to care, as well as population health outcomes including population viral load, HIV related mortality in men, and HIV incidence in young women (15-30 years of age).

Trial registration

This trial was registered on 28 November 2018 on, identifier https://​clinicaltrials.​gov/​.
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Metadata
Title
Home-based intervention to test and start (HITS) protocol: a cluster-randomized controlled trial to reduce HIV-related mortality in men and HIV incidence in women through increased coverage of HIV treatment
Authors
T. Mathenjwa
H.-Y. Kim
T. Zuma
M. Shahmanesh
J. Seeley
P. Matthews
S. Wyke
N. McGrath
B. Sartorius
H. M. Yapa
O. Adeagbo
A. Blandford
A. Dobra
T. Bäernighausen
F. Tanser
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-7277-0

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