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• W4289868711 abstract "<ns4:p><ns4:bold>Background: </ns4:bold>HIV-related stigma is a major barrier to the timely linkage and retention of patients in HIV care in sub-Saharan Africa, where most people living with HIV/AIDS reside. In this implementation study we aim to evaluate the effect of stigma-directed services on linkage to care and other health outcomes in newly diagnosed HIV-positive patients.</ns4:p><ns4:p> <ns4:bold>Methods</ns4:bold>: In a nested project of the Kilombero and Ulanga Antiretroviral Cohort in rural Tanzania, we conduct a prospective observational pre-post study to assess the impact of a bundle of stigma-directed services for newly diagnosed HIV positive patients. Stigma-directed services, delivered by a lay person living with HIV, are i) post-test counseling, ii) post-test video-assisted teaching, iii) group support therapy and group health education, and iv) mobile health. Patients receiving stigma services (enrolled from 1<ns4:sup>st</ns4:sup> February 2020 to 31<ns4:sup>st</ns4:sup> August 2021) are compared to a historical control receiving the standard of care (enrolled from 1<ns4:sup>st</ns4:sup> July 2017 to 1<ns4:sup>st</ns4:sup> February 2019). The primary outcome is ‘linkage to care’. Secondary endpoints are retention in care, viral suppression, death and clinical failure at 6-12 months (up to 31<ns4:sup>st</ns4:sup> August 2022). Self-reported stigma and depression are assessed using the Berger Stigma scale and the PHQ-9 questionnaire, respectively. The sample size calculation was based on cohort data from 2018. Assuming a pre-intervention cohort of 511 newly diagnosed adults of whom 346 (68%) were in care and on antiretroviral treatment (ART) at 2 months, a 10% increase in linkage (from 70 to 80%), a two-sided type I error rate of 5%, and 90% power, 321 adults are required for the post-implementation group.</ns4:p><ns4:p> <ns4:bold>Discussion: </ns4:bold>We expect that integration of stigma-directed services leads to an increase of proportions of patients in care and on ART. The findings will provide guidance on how to integrate stigma-directed services into routine care in rural sub-Saharan Africa.</ns4:p>" @default.
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• W4289868711 date "2022-08-05" @default.
• W4289868711 modified "2023-10-03" @default.
• W4289868711 title "Stigma-directed services (Stig2Health) to improve ‘linkage to care’ for people living with HIV in rural Tanzania: study protocol for a nested pre-post implementation study within the Kilombero and Ulanga Antiretroviral Cohort" @default.
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• W4289868711 doi "https://doi.org/10.12688/aasopenres.13353.2" @default.
• W4289868711 hasPublicationYear "2022" @default.
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