Implementation: Evaluations of Interventions to Improve Service Delivery
Although most CGHD studies on the economics and epidemiology of HIV are observational, we also implement and evaluate clinical trials and pilot projects. Current and recent evaluations are described below and on the linked pages.
- CATS: China Adherence through Technology Study. The CATS randomized controlled study is assessing the feasibility and acceptability of using real-time feedback and a wireless technology approach to promote ART adherence among Chinese injection drug users and identifying the factors that explain how real-time feedback influences intervention success or failure.
- OPTI-Q: Efficacy and Safety of Levofloxacin for the Treatment of Multi-Drug Resistant Tuberculosis. Nearly half a million cases of multi-drug TB occur annually around the world, causing 150,000 deaths. Current treatment regimens have a low success rate, and new drugs are urgently needed. Opti-Q is a randomized, placebo-controlled clinical trial in South Africa and Peru aimed at determining the best dose of one of these new drugs, levofloxacin, for treating MDR-TB.
- RapIT: Rapid Initiation of HIV Treatment in South Africa. One of the most serious challenges facing antiretroviral therapy (ART) programs for HIV/AIDS in both sub-Saharan Africa and in the U.S. is the failure of ART-eligible patients to complete the steps required to initiate treatment. One strategy proposed for reducing losses amongthose eligible for ART is to simplify and condense the steps required for starting treatment. This is now possible because new, point-of-care (POC) tests for CD4 counts and TB diagnosis are available. These technologies can be combined with changes to clinic schedules to allow all steps required for ART initiation to take place on the day the patient presents for an HIV test. RapIT is a randomized strategy evaluation of the feasibility, effectiveness, and cost-effectiveness of rapid ART initiation.
- RapIT NCD: Non-Communicable Diseases and Antiretroviral Therapy in the RapIT Study Population. In addition to very high HIV prevalence, South Africa faces high rates of noncommunicable diseases (NCD) like diabetes and NCD risk factors, like obesity and hypertension. The RapIT NCD study is screening stable ART patients 35 years or older for non-communicable conditions and risks and examining whether these are associated with ART outcomes such as mortality, loss to follow up, viral suppression and immunologic improvement, and physical functioning, ability to perform normal daily activities, and economic productivity.