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

Effectiveness of health care workers and peer engagement in promoting access to health services among population at higher risk for HIV in Tanzania (KPHEALTH): study protocol for a quasi experimental trial

Authors: Elia John Mmbaga, Germana Henry Leyna, Melkizedeck Thomas Leshabari, Britt Tersbøl, Theis Lange, Neema Makyao, Kåre Moen, Dan Wolf Meyrowitsch

Published in: BMC Health Services Research | Issue 1/2019

Abstract

Background

While there are indications of declining HIV infection rates in the general population globally, Tanzania included, men who have sex with men (MSM), female sex workers (FSW) and people who inject drugs (PWID), now called Key Populations (KP) for HIV epidemic have 2–20 times higher infections rates and contributes up to 30% of new HIV infection. Tanzania have developed a Comprehensive Guideline for HIV prevention among key population (CHIP) to address the epidemic among KPs. However, these populations are stigmatized and discriminated calling for innovative approaches to improve access to CHIP. This project seeks to test the effectiveness of healthcare workers and peer-to-peer engagement in promoting access to CHIP among HIV at risk populations in Tanzania.

Methods

A quasi-experimental design involving Dar es Salaam City as an intervention region and Tanga as a control region will be done. Using respondent driven sampling, 1800 at risk population (900 from Intervention site and 900 from control site) will be recruited at baseline to identify pull and push factors for health services access. Stakeholder’s consultation will be done to improve training contents for CHIP among health care workers and peers. Effectiveness of healthcare workers training and peer engagement will be tested using a quasi-experimental design.

Discussion

The results are expected to co-create service provision and improve access to services among KPs as a human right, reverse HIV infection rates among KPs and the general population, and improve social and economic wellbeing of Tanzanian.

Trial registration

Retrospectively registered on 28th August, 2019 with International Standard Randomized Clinical Trial Number (ISRCTN11126469).

UNAIDS. UNAIDS DATA updates: Strate of the epidemic. In. Geneva: UNAIDS; 2018.

Mmbaga EJMK, Makyao N, Mpembeni R, Leshabari MT. HIV and STI s among men who have sex with men in Dodoma municipality, Tanzania: a cross-sectional study. Sex Transm Infect. 2017;93(5):314–9.CrossRef

Mmbaga EJMK, Leyna GH, Mpembeni R, Leshabari MT. HIV prevalence and associated risk factors among men who have sex with men in Dar Es Salaam Tanzania. J Acquir Immune Defic Syndr. 2018;77(3):243–9.CrossRef

Mmbaga EJMK, Makyao N, Leshabari M. Prevalence and predictors of human immunodeficiency virus and selected sexually transmitted infections among people who inject drugs in Dar Es Salaam, Tanzania: a new focus to get to zero. Sex Transm Dis. 2017;44(2):79–84.CrossRef

Ouedraogo HGK-ZO, Grosso A, Goodman S, Samadoulougou BC, Tarnagda G, Baguiya A, Tiendrebeogo S, Lougue M, Sawadogo N, Traore Y, Barro N, Baral S, Kouanda S. Human immunodeficiency virus (HIV) among men who have sex with men: results of the first integrated biological and behavioral survey in Burkina Faso West Africa. BMC Public Health. 2019;19(1):5.CrossRef

Baral SSF, Cleghorn F, Beyrer C. Elevated risk for HIV infection among men who have sex with men in low- and middle-income countries 2000-2006: a systematic review. PLoS Med. 2007;4(12):e339.CrossRef

Ferré VMG-KF, Collin G, Dagnra AC, Le Hingrat Q, Jaquet A, Salou M, Descamps D, Charpentier C, Ekouevi DK. Prevalence of Human Papillomavirus, HIV and other sexually transmitted infections among men having sex with men in Togo: a national cross-sectional survey. Clin Infect Dis. 2019;6. https://doi.org/10.1093/cid/ciy1012.

Kamazima SKN, Kilama BHIV. prevalence and sexually Transmitted Infection among Female Sex Workers in Dar es salaam, Tanzania. In: Dar es Salaam, Tanzania: NACP Tanzania; 2010.

Ross MWMS. Kilonzo GP drug use careers and blood-borne pathogen risk behavior in male and female Tanzanian heroin injectors. Am J Trop Med Hyg. 2008;79(3):338–43.CrossRef

10.

Ross MWNJ, Ahaneku HO, Mbwambo J, McClelland RS. McCurdy SA high HIV seroprevalence, rectal STIs and risky sexual behavior in men who have sex with men in Dar Es Salaam and Tanga Tanzania. BMJ Open. 2014;4(8):e006175.CrossRef

11.

Williams MLMS, Bowen AM, Kilonzo GP, Atkinson JS, Ross MW, Leshabari MT. HIV seroprevalence in a sample of Tanzanian intravenous drug users. AIDS Educ Prev. 2009;21(5):474–83.CrossRef

12.

Wirtz ALTG, Kamba D, Gama V, Chalera R, Jumbe V, Kumwenda R, Mangochi M, Helleringer S, Beyrer C, Baral S. Geographical disparities in HIV prevalence and care among men who have sex with men in Malawi: results from a multisite cross-sectional survey. Lancet HIV. 2017;4(6):e260–9.CrossRef

13.

Strathdee SASJ. Epidemiology of HIV among injecting and non-injecting drug users: current trends and implications for intervention. Curr HIV/AIDS Rep. 2010;7(2):99–106.CrossRef

14.

Djomand GQS, Sullivan PS. HIV epidemic among key populations in West Africa. Curr Opin HIV AIDS. 2014;9(5):506–13.CrossRef

15.

Wirtz AL, Jumbe V, Trapence G, Kamba D, Umar E, Ketende S, Berry M, Strömdahl S, Beyrer C, Baral SD. HIV among men who have sex with men in Malawi: elucidating HIV prevalence and correlates of infection to inform HIV prevention. J Int AIDS Soc. 2013;16 Suppl 3:18742. https://doi.org/10.7448/IAS.16.4.18742.

16.

Johnson C. Off the Map: How HIV/AIDS Programming is failing same-sex practicing people in Africa. In: New York: International Gay and Lesbian Human Rights Commission (IGLHRC); 2007.

17.

Matovu JKBMG, Kiguli J, Nuwaha F, Mujisha G, Musinguzi J, Arinaitwe J, Wanyenze RK. Health providers' experiences, perceptions and readiness to provide HIV services to men who have sex with men and female sex workers in Uganda - a qualitative study. BMC Infect Dis. 2019;19(1):214.CrossRef

18.

Mlunde LBSB, Mbwambo JK. Correlates of health care seeking behaviour among people who inject drugs in Dar es Salaam, Tanzania. Int J Drug Policy. 2016;30:66–73. https://doi.org/10.1016/j.drugpo.2015.12.012).CrossRefPubMed

19.

Shangani SNV, Operario D, Genberg B. Stigma and healthcare-seeking practices of men who have sex with men in Western Kenya: a mixed-methods approach for scale validation. AIDS Patient Care STDs. 2018;32(11):477–86.CrossRef

20.

Mmbaga EJLG, Mpembeni R, Moen K, Makyao N, Leshabari M. Intergrated biobehavioral survey among men who have sex with men in Dar Es Salaam, Tanzania. Dar es Salaam: National AIDS Control Program, MUHAS; 2014.

21.

WHO. Consolidated Guidelines on HIV prevention, Diagnosis, Treatment and Care for Key Populations. 2016 updates. Geneva: WHO; 2016.

22.

Programme NAC. Comprehensive Guideline for HIV prevention among Key Population in Tanzania. In: Dar es Salaam, Tanzania: NACP; 2016.

23.

Moretta Tartaglione A, Cavacece Y, Cassia F, Russo G. The excellence of patient-centered healthcare: Investigating the links between empowerment, co-creation and satisfaction. TQM J. 2018;30(2):153–67.CrossRef

24.

Nordgren L. The performativity of the service management discourse: ‘value creating customers’ in health care. J Health Organ Manag. 2008;22(5):510–28.CrossRef

25.

Small N, Bower P, Chew-Graham C, Whalley D, Protheroe J. Patient empowerment in long-term conditions: development and preliminary testing of a new measure. BMC Health Serv Res. 2013;13(1):263–77.CrossRef

26.

Harker Burnhams NLR, Howell S, Shaw M, Erasmus J, Townsend L. Using respondent-driven sampling (RDS) to recruit illegal poly-substance users in Cape Town, South Africa: implications and future directions. Subst Abuse Treat Prev Policy. 2016;11(1):31.CrossRef

27.

DD H. Snowball versus respondent-driven sampling. Sociol Methodol. 2011;41(1):355–66.CrossRef

28.

Omary Ubuguyu OT. Douglas Bruce, frank Masao, Cassian Nyandindi, Norman Sabuni, Sheryl McCurdy, Jessie Mbwambo, Barrot Lambdin: improvements in health-related quality of life among methadone maintenance clients in Dar Es Salaam, Tanzania. Int J Drug Policy. 2016;30:74–81.CrossRef

29.

Tran OCBR, Masao F, Ubuguyu O, Sabuni N, Mbwambo J. Implementation and Operational Research: Linkage to Care Among Methadone Clients Living With HIV in Dar es Salaam, Tanzania. J Acquir Immune Defic Syndr. 2015;69(2):e43–8.CrossRef

30.

Zamudio-Haas S. mB, Saleem H generating trust: programmatic strategies to reach women who inject drugs with harm reduction services in Dar Es Salaam, Tanzania. Int J Drug Policy. 2016;30:43–51.CrossRef

31.

Lambdin BHBR. Chang O identifying programmatic gaps: inequities in harm reduction service utilization among male and female drug users in Dar Es Salaam Tanzania. PLoS One. 2013;8(6):e67062.CrossRef

32.

Wiley FMG. Health care system transformation and Intergration: a call to action for public health. J Law Med Ethics. 2017;45:94–7.CrossRef

Title: Effectiveness of health care workers and peer engagement in promoting access to health services among population at higher risk for HIV in Tanzania (KPHEALTH): study protocol for a quasi experimental trial
Authors: Elia John Mmbaga
Germana Henry Leyna
Melkizedeck Thomas Leshabari
Britt Tersbøl
Theis Lange
Neema Makyao
Kåre Moen
Dan Wolf Meyrowitsch
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Care
Human Immunodeficiency Virus
Published in: BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-019-4675-z

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Effectiveness of health care workers and peer engagement in promoting access to health services among population at higher risk for HIV in Tanzania (KPHEALTH): study protocol for a quasi experimental trial

Abstract

Background

Methods

Discussion

Trial registration

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Discussion

Trial registration

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