Evidence map›Paper›PMID 30659994›Full record

Trial reportDrug and alcohol dependence2019

Cluster randomized stepped-wedge trial of a multi-level HIV prevention intervention to decrease amphetamine-type stimulants and sexual risk in Cambodian female entertainment and sex workers.

Kimberly Page, Adam W Carrico, Ellen Stein, Jennifer Evans, Muth Sokunny, Phou Maly, Chhit Sophal, Yuthea Neak, Song Ngak, Charles McCulloch and 1 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Drug and alcohol dependence, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kimberly PageDepartment of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University New Mexico Health Sciences Center, Albuquerque, NM, USA; Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia. Electronic address: Pagek@salud.unm.edu.
Adam W CarricoDepartment of Public Health Sciences, Division of Prevention Science and Community Health, University of Miami, Miami, FL, USA; Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia. Electronic address: A.Carrico@miami.edu.
Ellen SteinDepartment of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA; Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia. Electronic address: Ellen.Stein@ucsf.edu.
Jennifer EvansDepartment of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA; Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia. Electronic address: Jennifer.Evans@ucsf.edu.
Muth SokunnyFHI 360, Phnom Penh, Cambodia; Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia. Electronic address: msokunny@gmail.com.
Phou MalyFHI 360, Phnom Penh, Cambodia; Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia. Electronic address: malyphoupsy@gmail.com.
Chhit SophalMinistry of Health, Department of Mental Health and Substance Abuse, Phnom Penh, Cambodia; Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia. Electronic address: Chhit_Sophal@hotmail.com.
Yuthea NeakNational Authority for Combating Drugs, Phnom Penh, Cambodia; Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia. Electronic address: neakyuthea@yahoo.com.
Song NgakFHI 360, Phnom Penh, Cambodia; Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia. Electronic address: Sngak@fhi360.com.
Charles McCullochDepartment of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA; Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia. Electronic address: Charles.McCulloch@ucsf.edu.
Lisa MaherMinistry of Health, Department of Mental Health and Substance Abuse, Phnom Penh, Cambodia; Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia. Electronic address: Lisa.Maher@kirby.unsw.edu.au.

Funding

Cambodia Integrated HIV and Drug Prevention Implementation ProgramR01DA033672 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI PAGE, KIMBERLY, STEIN, ELLEN · 2012 to 2016
$2.6M
NIDA NIH HHS R01 DA033672
6 · The paper itself

Abstract

backgroundHIV prevention for female entertainment and sex workers (FESW) may be optimized by addressing individual and structural risks. We examined the impact of a sequentially delivered intervention to decrease sexual risk, amphetamine-type stimulant (ATS) use, and improve economic well-being in Cambodian FESW.

methodsA cluster randomized stepped-wedge trial was conducted in 10 Cambodian provinces to test multi-level intervention in high risk FESW. After baseline screening in 1198 women, those screening positive for ATS use disorder were allocated to a 12-week conditional cash transfer intervention followed by a 4-week cognitive-behavioural aftercare group (CCT + AC). At six months, ATS abstinent participants were offered a microenterprise (ME) opportunity. Co-primary outcomes assessed in 600 FESW at each 6-, 12- and 18-month follow-up assessments, included: 1) number of sexual partners (past three months); and 2) ATS urine toxicology positive (Tox+) results. Secondary outcomes included indicators of economic well-being.

resultsRelative to baseline, FESW reported fewer sexual partners at all follow-up assessments with a significant 50% decrease at 12-months (Adjusted Rate Ratio [ARR] = 0.50; 95%CI: 0.25, 0.95). Women had 60% lower odds of being ATS Tox+ (Adjusted Odds Ratio [AOR] = 0.40; 95%CI: 0.25, 0.65) at 6-months, and continued but non-significant reductions at 12- and 18-months. Improvements in economic well-being indicators were observed at 12- and 18-months.

conclusionsFindings support the robust effectiveness of the sequentially delivered CCT + AC and ME interventions for boosting HIV prevention for Cambodian FESW. Further research is needed to inform the scale up and improve durability of this comprehensive approach with FESW in Southeast Asia.

Indexed as

Asian PeopleSex WorkersAdultAmphetamineAmphetamine-Related DisordersCentral Nervous System StimulantsCluster AnalysisCognitive Behavioral TherapyFemaleFollow-Up StudiesHIV InfectionsHumansSexual BehaviorSex WorkUnsafe SexYoung AdultAmphetamineCentral Nervous System StimulantsAmphetamine-type stimulantsConditional cash transferContingency managementHIV preventionMicroenterpriseSex work

Identifiers

PMID30659994
PMCPMC6392432

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.