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Table 2 Intervention arm: Enhanced Linkage to Care

From: Efficacy of an enhanced linkage to HIV care intervention at improving linkage to HIV care and achieving viral suppression following home-based HIV testing in rural Uganda: study protocol for the Ekkubo/PATH cluster randomized controlled trial

 

Intervention session core components

Session 1, Baseline home visit

Protocol Components 1-8

30 min

1. Explain linkage to HIV care

2. Assessment of potential adverse effects

3. Assess needs/barriers to HIV care

4. Provide counseling to overcome barriers

  a. Assess HIV-related stigma

  b. Counseling to overcome stigma

  c. Identify sources of social support

  d. Provide referrals for social support

  e. Counseling to address other barriers

5. Help the client plan for disclosure, seeking social support, and HIV stigma

  a. Create a disclosure plan

  b. Identify treatment supporter(s)

  c. Encourage support seeking

6. Orient client to the HIV care system and process

7. Elicit client’s intention to seek HIV care

8. Set the time/date for two-week CD4 result home visit

Session 2, Two-week CD4 results home visit

30 min

1. Provide CD4 results and explain what they mean. If not eligible for treatment explain importance of repeat CD4 testing every 3 months

2. Review plans and discuss client’s plans from Session 1

3. Assess if client has linked to care

4. Assess the participant’s needs/barriers to care and provide counseling/referrals

a. If patient has not been linked: As appropriate, repeat components 1-7 from Session 1

b. If patient has been linked: As appropriate, repeat components 1-6 from Session 1 in relation to continued linkage

5. Assess HIV-related stigma and if client has disclosed and sought social support.

6. As needed provide counseling on seeking social support

7. Assess and discuss disclosure

8. Discuss treatment supporter

9. Review barriers and plans for overcoming barriers and getting social support

10. Elicit client’s intention to seek HIV care/attend second clinic visit

11. Set the date/time for the next home visit

Session 3, Six-week home visit

30 min

Repeat steps outlined in Session 2

Session 4, First HIV clinic visit

30 min

1. Congratulate client on attending the HIV clinic

2. Assess client’s barriers to attending a second clinic visit

3. Assess if client sought social support and if needed provide counseling on seeking social support

4. Address any other barriers to care and any medical needs

5. Review barriers to care, plans for overcoming barriers and getting social support

6. Elicit intention to attend the next clinic visit

Optional Session 5 & 6, Additional visit/phone calls

30 min

Up to two calls those lost to follow up, repeat Session 3

If cannot be reached via phone, one home visit for those lost to follow up, repeat Session 3