Evidence map›Paper›PMID 38693537›Full record

Trial reportBMC health services research2024

Reducing time to differentiated service delivery for newly-diagnosed people living with HIV in Kigali, Rwanda: a pilot, unblinded, randomized controlled trial.

Jonathan Ross, Kathryn Anastos, Sarah Hill, Eric Remera, Gallican N Rwibasira, Charles Ingabire, Francine Umwiza, Athanase Munyaneza, Benjamin Muhoza, Chenshu Zhang and 3 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04567693 (Reducing Time to Spaced-out Appointments for Newly-diagnosed People Living With HIV), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.2field-weighted citation impact, top 24% of its field
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.

NCT04567693 nacompletednot on this map

Reducing Time to Spaced-out Appointments for Newly-diagnosed People Living With HIV: a Pilot Study

TypeinterventionalSponsorMontefiore Medical CenterRan2020 to 2022Enrolled93ConditionsHiv, AidsArmsEarly spaced-out appointments
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
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

13 authors at 4 institutions in 2 countries.

Jonathan RossAlbert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY, 10467, USA. joross@montefiore.org.
Kathryn AnastosAlbert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY, 10467, USA.
Sarah HillAlbert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY, 10467, USA.
Eric RemeraDivision of HIV, STIs and Viral Hepatitis, Rwanda Biomedical Center, Kigali, Rwanda.
Gallican N RwibasiraDivision of HIV, STIs and Viral Hepatitis, Rwanda Biomedical Center, Kigali, Rwanda.
Charles IngabireResearch for Development (RD Rwanda), Kigali, Rwanda.
Francine UmwizaResearch for Development (RD Rwanda), Kigali, Rwanda.
Athanase MunyanezaResearch for Development (RD Rwanda), Kigali, Rwanda.
Benjamin MuhozaResearch for Development (RD Rwanda), Kigali, Rwanda.
Chenshu ZhangAlbert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY, 10467, USA.
Denis NashInstitute for Implementation Science in Population Health, City University of New York, New York, 10027, USA.
Marcel Yotebieng *Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY, 10467, USA.
Gad Murenzi *Research for Development (RD Rwanda), Kigali, Rwanda.
Albert Einstein College of Medicine · USRwanda Development Board · RWRwanda Biomedical Center · RWPopulation Council · US

Funding

"Enhancing Cancer Research in Central Africa IeDEA"U01AI096299 · NIAID · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI Denis Nash, Marcel Yotebieng · 2011 to 2026
$35.8M
Einstein-Montefiore Clinical and Translational Science Award HubUM1TR004400 · NCATS · ALBERT EINSTEIN COLLEGE OF MEDICINE · PI Jessica Kahn, Mimi Y Kim · 2023 to 2026
$17.3M
Minimizing losses from HIV care under universal treatment in RwandaK23MH114752 · NIMH · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI ROSS, JONATHAN · 2017 to 2021
$995k
NCATS NIH HHS UM1 TR004400NIAID NIH HHS U01 AI096299NIMH NIH HHS K23 MH114752
6 · The paper itself

Abstract

backgroundDifferentiated service delivery (DSD) programs for people living with HIV (PWH) limit eligibility to patients established on antiretroviral therapy (ART), yet uncertainty exists regarding the duration on ART necessary for newly-diagnosed PWH to be considered established. We aimed to determine the feasibility, acceptability, and preliminary impact of entry into DSD at six months after ART initiation for newly-diagnosed PWH.

methodsWe conducted a pilot randomized controlled trial in three health facilities in Rwanda. Participants were randomized to: (1) entry into DSD at six months after ART initiation after one suppressed viral load (DSD-1VL); (2) entry into DSD at six months after ART initiation after two consecutive suppressed viral loads (DSD-2VL); (3) treatment as usual (TAU). We examined feasibility by examining the proportion of participants assigned to intervention arms who entered DSD, assessed acceptability through patient surveys and by examining instances when clinical staff overrode the study assignment, and evaluated preliminary effectiveness by comparing study arms with respect to 12-month viral suppression.

resultsAmong 90 participants, 31 were randomized to DSD-1VL, 31 to DSD-2VL, and 28 to TAU. Among 62 participants randomized to DSD-1VL or DSD-2VL, 37 (60%) entered DSD at 6 months while 21 (34%) did not enter DSD because they were not virally suppressed. Patient-level acceptability was high for both clinical (mean score: 3.8 out of 5) and non-clinical (mean score: 4.1) elements of care and did not differ significantly across study arms. Viral suppression at 12 months was 81%, 81% and 68% in DSD-1VL, DSD-2VL, and TAU, respectively (p = 0.41).

conclusionsThe majority of participants randomized to intervention arms entered DSD and had similar rates of viral suppression compared to TAU. Results suggest that early DSD at six months after ART initiation is feasible for newly-diagnosed PWH, and support current WHO guidelines on DSD.

trial registrationClinicaltrials.gov NCT04567693; first registered on September 28, 2020.

Indexed as

HIV InfectionsViral LoadAdultAnti-HIV AgentsDelivery of Health CareFemaleHumansMaleMiddle AgedPatient Acceptance of Health CarePilot ProjectsRwandaTime FactorsAnti-HIV AgentsDifferentiated service deliveryHIVNew diagnosisRwandaSub-Saharan Africa

Identifiers

PMID38693537
PMCPMC11062003
OpenAlexW4396547840

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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.