(Q28948)

Statements

Transgender-Specific Differentiated HIV Service Delivery Models in the South African Public Primary Health Care System (Jabula Uzibone): Protocol for an Implementation Study. (English)
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Almost 60% of transgender people in South Africa are living with HIV. (English)
BACKGROUND (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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Ending the HIV epidemic will require that transgender people successfully access HIV prevention and treatment. (English)
BACKGROUND (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
1 reference
However, transgender people often avoid health services due to facility-based stigma and lack of availability of gender-affirming care. (English)
BACKGROUND (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
1 reference
Transgender-specific differentiated service delivery (TG-DSD) may improve engagement and facilitate progress toward HIV elimination. (English)
BACKGROUND (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
1 reference
Wits RHI, a renowned South African research institute, established 4 TG-DSD demonstration sites in 2019, with funding from the US Agency for International Development. (English)
BACKGROUND (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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These sites offer unique opportunities to evaluate the implementation of TG-DSD and test their effectiveness. (English)
BACKGROUND (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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The Jabula Uzibone study seeks to assess the implementation, effectiveness, and cost of TG-DSD for viral suppression and prevention-effective adherence. (English)
OBJECTIVE (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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The Jabula Uzibone study collects baseline and 12-month observation checklists at 8 sites and 6 (12.5%) key informant interviews per site at 4 TG-DSD and 4 standard sites (n=48). (English)
METHODS (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
1 reference
We seek to enroll ≥600 transgender clients, 50% at TG-DSD and 50% at standard sites: 67% clients with HIV and 33% clients without HIV per site type. (English)
METHODS (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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Participants complete interviewer-administered surveys quarterly, and blood is drawn at baseline and 12 months for HIV RNA levels among participants with HIV and tenofovir levels among participants on pre-exposure prophylaxis. (English)
METHODS (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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A subset of 30 participants per site type will complete in-depth interviews at baseline and 12 months: 15 participants will be living with HIV and 15 participants will be HIV negative. (English)
METHODS (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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Qualitative analyses will explore aspects of implementation; regression models will compare viral suppression and prevention-effective adherence by site type. (English)
METHODS (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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Structural equation modeling will test for mediation by stigma and gender affirmation. (English)
METHODS (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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Microcosting approaches will estimate the cost per service user served and per service user successfully treated at TG-DSD sites relative to standard sites, as well as the budget needed for a broader implementation of TG-DSD. (English)
METHODS (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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Funded by the US National Institutes of Mental Health in April 2022, the study was approved by the Human Research Ethics Committee at University of Witwatersrand in June 2022 and the Duke University Health System Institutional Review Board in June 2023. (English)
RESULTS (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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Enrollment began in January 2024. (English)
RESULTS (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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As of July 31, 2024, a total of 593 transgender participants have been enrolled: 348 are living with HIV and 245 are HIV negative. (English)
RESULTS (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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We anticipate baseline enrollment will be complete by August 31, 2024, and the final study visit will take place no later than August 2025. (English)
RESULTS (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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Jabula Uzibone will provide data to inform HIV policies and practices in South Africa and generate the first evidence for implementation of TG-DSD in sub-Saharan Africa. (English)
CONCLUSIONS (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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Study findings may inform the use of TG-DSD strategies to increase care engagement and advance global progress toward HIV elimination goals. (English)
CONCLUSIONS (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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DERR1-10.2196/64373. (English)
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) (English)
©Tonia Poteat, Rutendo Bothma, Innocent Maposa, Cheryl Hendrickson, Gesine Meyer-Rath, Naomi Hill, Audrey Pettifor, John Imrie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024. (English)
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13 September 2024
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13 September 2024
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13
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e64373
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e64373
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Conflicts of Interest: None declared. (English)
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