HIVPhase 2/3CTN 0056NCT02084316
Testing and Linkage to HIV Care in China
A Phase 2/3 study testing One4All in people with HIV, run by University of California, Los Angeles at 12 sites in China.
Trial summary
This study will evaluate the effects of a comprehensive approach (One4All) to increase the percentage of patients that receive their HIV testing results and counseling. Primary Hypothesis: The One4All approach will increase the proportion of individuals who have completed all tests to confirm HIV diagnosis and… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- HIV
- What is being tested?
- One4All
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 360 participants
- Where
- 12 sitesChina
- Study dates
- Mar 2014to Jan 2016
- Phase
- Phase 2/3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Participating individuals must:
- Be at least 18 years old
- Be an inpatient or outpatient seeking care in study hospitals
- Test positive on an initial EIA HIV screen
- Have local residency or intent to live in study area for at least 90 days
Who cannot join
- Individuals will be excluded from study participation if they:
- Do not meet any one or more of the above inclusion criteria
- Test result negative on initial EIA HIV screen
- Have previously received confirmation on HIV infection in the study hospital or in any other setting (e.g., CDC clinic, infectious disease hospital, sub-county-level hospital)
- Are prisoners or detainees at the time of initial screening
- Are pregnant women (pregnant women are subject to mandatory testing)
Trial locations and contacts
12 sites in 1 country.
12 sites in 1 country
China12 sites
Daxin County People's Hospital
Chongzu, Guangxi
Fusui County People's Hospital
Chongzuo, Guangxi
Ningming County People's Hospital
Chongzuo, Guangxi
Lingui County People's Hospital
Guilin, Guangxi
Lipu County People's Hospital
Guilin, Guangxi
Duan County People's Hospital
Hechi, Guangxi
Xiangzhou County People's Hospital
Laibin, Guangxi
Rongan County People's Hospital
Liuzhou, Guangxi
Longan County People's Hospital
Nanning, Guangxi
Lingshan County People's Hospital
Qingzhoucun, Guangxi
Cenxi County People's Hospital
Wuzhou, Guangxi
Bobai County People's Hospital
Yulin, Guangxi
About this study
Official title: Testing and Linkage to HIV Care in China: A Clustered Randomized Trial
This study will evaluate the effects of a comprehensive approach (One4All) to increase the percentage of patients that receive their HIV testing results and counseling.
Primary Hypothesis: The One4All approach will increase the proportion of individuals who have completed all tests to confirm HIV diagnosis and received counseling within 30 days of screening HIV+, given they have screened HIV+ on the initial test, from 40% to 60%.
Read the detailed description
The study consists of a cluster randomized trial (CRT) at county hospitals in Guangxi, China to assess the effectiveness of a structural intervention: a new testing algorithm, consisting of rapid point-of-care (POC) HIV and CD4 testing, with viral load (VL) testing in parallel, designed to ensure completeness of diagnostic assessment and accelerate time to ART initiation for patients deemed ART eligible (hereafter called the One4all Test Intervention).
This CRT will be conducted in 12 county general hospitals with an estimated average of 30 participants per hospital, totaling an estimated 360 participants. The unit of randomization is the hospital. Hospitals will be randomized to 1) theOne4all Test Intervention, or 2) the control condition, consisting of the current standard of care (SOC). The efficacy of the intervention will be evaluated at 1, 3, and 12 month follow-up assessments, and the differential efficacy for drug users (DUs) and non-drug users will be examined.
The study population will consist of adult participants who screen positive on an initial HIV enzyme immunoassay (EIA) in the 12 study hospitals. Since the study will be conducted in China, the vast majority of participants will be of Chinese or Asian descent. Women will be included and are expected to represent approximately 26% of the study population.
Eligibility Criteria:
Site Eligibility Criteria: The location of our study is Guangxi Zhuang Autonomous Region (Guangxi). We will select county-level general hospitals in order to ensure sufficient caseload at each hospital and homogeneity across hospitals. Guangxi counties usually have one general hospital (a limited number of counties have two or more general hospitals); this hospital has been designated as the only setting for delivering ART services in the respective county.
Study hospitals (n=12) will be selected based on the number of reported HIV positive screenings in the first 6 months of the previous year (2012) and on homogeneity in testing procedures between hospitals. Selected hospitals will have reported at least 30 patients who screened positive during the period of January to June 2012. Should more than 12 hospitals be identified the lowest screen positive hospital will not be considered for participation.
Participant Eligibility Criteria: Inclusion criteria will be 1) age 18 or older, 2) seeking care in study hospitals, 3) local residency or intent to live in study area for at least 90 days, and 4) received HIV positive results on the initial screening test. Any patient who does not meet these inclusion criteria will be excluded from the study. Additionally, patients who are pregnant or who have previously received confirmation of HIV infection in other care settings (e.g. CDC clinic, infectious disease hospital, sub-county-level hospital) are not eligible to participate. Any patient who is a prisoner or detainee at the time of initial screening will be excluded from the study. In the event that a participant is enrolled at a study hospital and subsequently incarcerated, data will be collected.
- Conditions
- HIV
- Being tested
- One4All, Standard of Care
- Keywords
- China CDC, One4All testing algorithm, Guangxi Autonomous Region, Testing and Linkage to HIV Care in China
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
One4AllBehavioural
Participants with HIV-positive screening results on EIA will immediately have their blood drawn for CD4 and VL tests. Participants will receive post-screening test counseling. Two venous blood samples will be collected-one for immediate numeration of CD4 T-lymphocytes in the same hospital lave using PIMA POC CD4 analyzer and the other for later VL testing at the province CDC which takes 10-15 days. Participant will be notified in person of their CD4 results on the same day and provided post-CD4 test counseling. Counseling in the One4all intervention has been modified from the national SOC guidelines due to the different order of tests and the shortened time period between screening and CD4 testing. The participant will be provided with a tentative assessment of ART eligibility based on CD4 results and other factors. Those who are eligible for ART are encouraged to seek HIV care at the study hospitals via China's National Free ART program.
Standard of CareBehavioural
The control condition is the current standard of care (SOC) utilized within the county hospitals in Guangxi China. This SOC has some variability between counties but in general follows the national policies. After the initial positive screening on EIA and subsequent repeat screening, participants will receive post-screening test counseling. Participants will then be tested by WB either at the same visit or a subsequent visit. The WB is sent offsite.
After WB test results are reported to the hospital, the health care provider will contact the participant by phone. The participant will be asked to return to the hospital for results and post-WB test counseling. At this visit, a blood sample will be collected for CD4 testing, and an initial epidemiological investigation will be carried out.
Once CD4 test results are available, participants must be located again to inform them of their results and ART eligibility and to provide post-CD4 test counseling.
| Study group | Role | What they receive |
|---|---|---|
| One4All | Experimental | Participants with HIV-positive screening results on EIA will immediately have their blood drawn for CD4 and VL tests. Participants will receive post-screening test counseling. Two venous blood samples will be collected-one for immediate numeration of CD4 T-lymphocytes in the same hospital lave using PIMA POC CD4 analyzer and the other for later VL testing at the province CDC which takes 10-15 days. Participant will be notified in person of their CD4 results on the same day and provided post-CD4 test counseling. Counseling in the One4all intervention has been modified from the national SOC guidelines due to the different order of tests and the shortened time period between screening and CD4 testing. The participant will be provided with a tentative assessment of ART eligibility based on CD4 results and other factors. Those who are eligible for ART are encouraged to seek HIV care at the study hospitals via China's National Free ART program. Receives: Behavioral: One4All |
| Standard of Care | Active comparator | The control condition is the current standard of care (SOC) utilized within the county hospitals in Guangxi China. This SOC has some variability between counties but in general follows the national policies. After the initial positive screening on EIA and subsequent repeat screening, participants will receive post-screening test counseling. Participants will then be tested by WB either at the same visit or a subsequent visit. The WB is sent offsite.
After WB test results are reported to the hospital, the health care provider will contact the participant by phone. The participant will be asked to return to the hospital for results and post-WB test counseling. At this visit, a blood sample will be collected for CD4 testing, and an initial epidemiological investigation will be carried out.
Once CD4 test results are available, participants must be located again to inform them of their results and ART eligibility and to provide post-CD4 test counseling. Receives: Behavioral: Standard of Care |
What is being measured
The primary outcome is the main question the study is designed to answer.
Receipt of post-test results and counseling following testing completeness
The numerator is the number of HIV-positive participants who have received post-test results and counseling within 30 days of initial screening blood draw. The denominator is the number of participants who screened positive on the initial HIV EIA in the study arm (control or intervention).
Measured: 30 days
Secondary outcomes (1)
Proportion of treatment-eligible participants with CD4 < 350
A secondary outcome is the proportion of treatment-eligible participants with CD4< 350 cells/mm3 who have initiated ART within 90 days of an initial positive HIV screening. We will define the secondary endpoint variable for hypothesis as a binary variable. If a participant with CD4 <350 cells/mm3 initiates ART within 90 days of a positive screening, the variable is defined equal to one. Otherwise, the variable is defined equal to zero. All participants who screened HIV-positive on the initial EIA at screening will be included in the analysis.
Measured: 90 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Mar 2014 (estimated)
- Study startMar 2014
- Primary completionAug 2014
- Study completionJan 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for HIVStudies of the same condition, open and under way.
- More trials run by University of California, Los AngelesThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2/3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 360 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of California, Los Angeles
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute on Drug Abuse (NIDA)
- Responsible party
- Principal investigator, Walter Ling, University of California, Los Angeles
- Investigators
- Zunyou Wu, MD, PhD, Principal investigator, National Center for AIDS/STD Control and PreventionWalter Ling, MD, Principal investigator, University of California, Los AngelesRoger Detels, MD, MS, Principal investigator, University of California, Los Angeles
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02084316
- Sponsor's protocol ID
- NIDA CTN 0056
- Other IDs
- U10DA013045
- Acronym
- CTN 0056
- Status last verified
- Jan 2016
- First submitted
- 7 Mar 2014
- Last updated
- 18 Aug 2016
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Wu Z, Tang Z, Mao Y, Van Veldhuisen P, Ling W, Liu D, Shen Z, Detels R, Lan G, Erinoff L, Lindblad R, Gu D, Tang H, Hu L, Zhu Q, Lu L, Oden N, Hasson AL, Zhao Y, McGoogan JM, Ge X, Zhang N, Rou K, Zhu J, Wei H, Shi CX, Jin X, Li J, Montaner JSG. Testing and linkage to HIV care in China: a cluster-randomised trial. Lancet HIV. 2017 Dec;4(12):e555-e565. doi: 10.1016/S2352-3018(17)30131-5. Epub 2017 Aug 31.
PubMed 28867267Mao Y, Wu Z, McGoogan JM, Liu D, Gu D, Erinoff L, Ling W, VanVeldhuisen P, Detels R, Hasson AL, Lindblad R, Montaner JSG, Tang Z, Zhao Y. Care cascade structural intervention versus standard of care in the diagnosis and treatment of HIV in China: a cluster-randomized controlled trial protocol. BMC Health Serv Res. 2017 Jun 12;17(1):397. doi: 10.1186/s12913-017-2323-z.
PubMed 28606085
Study at a glance
From the registry record, last updated by the sponsor on 18 Aug 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Testing and Linkage to HIV Care in China: A Clustered Randomized Trial
- ClinicalTrials.gov ID
- NCT02084316
- Acronym / sponsor ID
- CTN 0056 / NIDA CTN 0056
- Conditions
- HIV
- Keywords
- China CDC, One4All testing algorithm, Guangxi Autonomous Region, Testing and Linkage to HIV Care in China
- Phase
- Phase 2/3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 360 participants (actual)
- Lead sponsor
- University of California, Los AngelesUniversity, hospital or other
- Collaborators
- National Institute on Drug Abuse (NIDA)
- Study start
- Mar 2014
- Primary completion
- Aug 2014 (actual)
- Study completion
- Jan 2016 (actual)
- First posted
- 11 Mar 2014 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will evaluate the effects of a comprehensive approach (One4All) to increase the percentage of patients that receive their HIV testing results and counseling.
Primary Hypothesis: The One4All approach will increase the proportion of individuals who have completed all tests to confirm HIV diagnosis and received counseling within 30 days of screening HIV+, given they have screened HIV+ on the initial test, from 40% to 60%.
Detailed description
The study consists of a cluster randomized trial (CRT) at county hospitals in Guangxi, China to assess the effectiveness of a structural intervention: a new testing algorithm, consisting of rapid point-of-care (POC) HIV and CD4 testing, with viral load (VL) testing in parallel, designed to ensure completeness of diagnostic assessment and accelerate time to ART initiation for patients deemed ART eligible (hereafter called the One4all Test Intervention).
This CRT will be conducted in 12 county general hospitals with an estimated average of 30 participants per hospital, totaling an estimated 360 participants. The unit of randomization is the hospital. Hospitals will be randomized to 1) theOne4all Test Intervention, or 2) the control condition, consisting of the current standard of care (SOC). The efficacy of the intervention will be evaluated at 1, 3, and 12 month follow-up assessments, and the differential efficacy for drug users (DUs) and non-drug users will be examined.
The study population will consist of adult participants who screen positive on an initial HIV enzyme immunoassay (EIA) in the 12 study hospitals. Since the study will be conducted in China, the vast majority of participants will be of Chinese or Asian descent. Women will be included and are expected to represent approximately 26% of the study population.
Eligibility Criteria:
Site Eligibility Criteria: The location of our study is Guangxi Zhuang Autonomous Region (Guangxi). We will select county-level general hospitals in order to ensure sufficient caseload at each hospital and homogeneity across hospitals. Guangxi counties usually have one general hospital (a limited number of counties have two or more general hospitals); this hospital has been designated as the only setting for delivering ART services in the respective county.
Study hospitals (n=12) will be selected based on the number of reported HIV positive screenings in the first 6 months of the previous year (2012) and on homogeneity in testing procedures between hospitals. Selected hospitals will have reported at least 30 patients who screened positive during the period of January to June 2012. Should more than 12 hospitals be identified the lowest screen positive hospital will not be considered for participation.
Participant Eligibility Criteria: Inclusion criteria will be 1) age 18 or older, 2) seeking care in study hospitals, 3) local residency or intent to live in study area for at least 90 days, and 4) received HIV positive results on the initial screening test. Any patient who does not meet these inclusion criteria will be excluded from the study. Additionally, patients who are pregnant or who have previously received confirmation of HIV infection in other care settings (e.g. CDC clinic, infectious disease hospital, sub-county-level hospital) are not eligible to participate. Any patient who is a prisoner or detainee at the time of initial screening will be excluded from the study. In the event that a participant is enrolled at a study hospital and subsequently incarcerated, data will be collected.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| One4All | Experimental | Behavioral: One4AllParticipants with HIV-positive screening results on EIA will immediately have their blood drawn for CD4 and VL tests. Participants will receive post-screening test counseling. Two venous blood samples will be collected-one for immediate numeration of CD4 T-lymphocytes in the same hospital lave using PIMA POC CD4 analyzer and the other for later VL testing at the province CDC which takes 10-15 days. Participant will be notified in person of their CD4 results on the same day and provided post-CD4 test counseling. Counseling in the One4all intervention has been modified from the national SOC guidelines due to the different order of tests and the shortened time period between screening and CD4 testing. The participant will be provided with a tentative assessment of ART eligibility based on CD4 results and other factors. Those who are eligible for ART are encouraged to seek HIV care at the study hospitals via China's National Free ART program. |
| Standard of Care | Active comparator | Behavioral: Standard of CareThe control condition is the current standard of care (SOC) utilized within the county hospitals in Guangxi China. This SOC has some variability between counties but in general follows the national policies. After the initial positive screening on EIA and subsequent repeat screening, participants will receive post-screening test counseling. Participants will then be tested by WB either at the same visit or a subsequent visit. The WB is sent offsite. After WB test results are reported to the hospital, the health care provider will contact the participant by phone. The participant will be asked to return to the hospital for results and post-WB test counseling. At this visit, a blood sample will be collected for CD4 testing, and an initial epidemiological investigation will be carried out. Once CD4 test results are available, participants must be located again to inform them of their results and ART eligibility and to provide post-CD4 test counseling. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Be at least 18 years old
- Be an inpatient or outpatient seeking care in study hospitals
- Test positive on an initial EIA HIV screen
- Have local residency or intent to live in study area for at least 90 days
Key exclusion criteria (6 listed)
- Do not meet any one or more of the above inclusion criteria
- Test result negative on initial EIA HIV screen
- Have previously received confirmation on HIV infection in the study hospital or in any other setting (e.g., CDC clinic, infectious disease hospital, sub-county-level hospital)
- Are prisoners or detainees at the time of initial screening
- Are pregnant women (pregnant women are subject to mandatory testing)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| One4AllParticipants with HIV-positive screening results on EIA will immediately have their blood drawn for CD4 and VL tests. Participants will receive post-screening test counseling. Two venous blood samples will be collected-one for immediate numeration of CD4 T-lymphocytes in the same hospital lave using PIMA POC CD4 analyzer and the other for later VL testing at the province CDC which takes 10-15 days. Participant will be notified in person of their CD4 results on the same day and provided post-CD4 test counseling. Counseling in the One4all intervention has been modified from the national SOC guidelines due to the different order of tests and the shortened time period between screening and CD4 testing. The participant will be provided with a tentative assessment of ART eligibility based on CD4 results and other factors. Those who are eligible for ART are encouraged to seek HIV care at the study hospitals via China's National Free ART program. | Behavioural | One4All |
| Standard of CareThe control condition is the current standard of care (SOC) utilized within the county hospitals in Guangxi China. This SOC has some variability between counties but in general follows the national policies. After the initial positive screening on EIA and subsequent repeat screening, participants will receive post-screening test counseling. Participants will then be tested by WB either at the same visit or a subsequent visit. The WB is sent offsite. After WB test results are reported to the hospital, the health care provider will contact the participant by phone. The participant will be asked to return to the hospital for results and post-WB test counseling. At this visit, a blood sample will be collected for CD4 testing, and an initial epidemiological investigation will be carried out. Once CD4 test results are available, participants must be located again to inform them of their results and ART eligibility and to provide post-CD4 test counseling. | Behavioural | Standard of Care |
Primary outcome
Receipt of post-test results and counseling following testing completeness
Time frame: 30 days
The numerator is the number of HIV-positive participants who have received post-test results and counseling within 30 days of initial screening blood draw. The denominator is the number of participants who screened positive on the initial HIV EIA in the study arm (control or intervention).
1 secondary outcome
Proportion of treatment-eligible participants with CD4 < 350
Time frame: 90 days
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Aug 2016.
- Derived from this study: PubMed 28867267Wu Z, Tang Z, Mao Y, Van Veldhuisen P, Ling W, Liu D, Shen Z, Detels R, Lan G, Erinoff L, Lindblad R, Gu D, Tang H, Hu L, Zhu Q, Lu L, Oden N, Hasson AL, Zhao Y, McGoogan JM, Ge X, Zhang N, Rou K, Zhu J, Wei H, Shi CX, Jin X, Li J, Montaner JSG. Testing and linkage to HIV care in China: a cluster-randomised trial. Lancet HIV. 2017 Dec;4(12):e555-e565. doi: 10.1016/S2352-3018(17)30131-5. Epub 2017 Aug 31.
- Derived from this study: PubMed 28606085Mao Y, Wu Z, McGoogan JM, Liu D, Gu D, Erinoff L, Ling W, VanVeldhuisen P, Detels R, Hasson AL, Lindblad R, Montaner JSG, Tang Z, Zhao Y. Care cascade structural intervention versus standard of care in the diagnosis and treatment of HIV in China: a cluster-randomized controlled trial protocol. BMC Health Serv Res. 2017 Jun 12;17(1):397. doi: 10.1186/s12913-017-2323-z.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Zunyou Wu, MD, PhD principal investigator
National Center for AIDS/STD Control and Prevention
Walter Ling, MD principal investigator
University of California, Los Angeles
Roger Detels, MD, MS principal investigator
University of California, Los Angeles
12 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2/3 study testing One4All in people with HIV, run by University of California, Los Angeles at 12 sites in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 18 Aug 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 12 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Receipt of post-test results and counseling following testing completeness (time frame: 30 days). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02084316, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Aug 2016.