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

Abstract

CM developed the protocol for this cluster randomized stepped-wedge trial with comments and feedback from the entire study team. KP, AWS, ES, MS, PM and SN developed and implemented standard operating procedures for conducting assessments as well as delivering the multi-level CIPI intervention and ensuring protocol fidelity. AWC and CS adapted evidence-based CCT and cognitive-behavioural interventions targeting stimulant use with substantial contributions by Ean Nil (see acknowledgements). ES and KP developed the ME opportunity protocol with substantial support from MS and SN to identify in-country collaborators to provide microloans. CS and NY led efforts to coordinate with local governmental officials and non-governmental organizations through orientation workshops conducted in each of the ten provinces for efficient implementation of this trial. Analyses were conducted by JE with substantial feedback from KP, CM, AWC, and ES.

How much is enough? Exploring the dose-response relationship between cash transfers and surgical utilization in a resource-poor setting

“…Cash transfers are common instruments in LMICs. [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] Over the last 10 years, scientific publications have evaluated cash transfer programs in 31 countries. The studies looked at the…”

“…impact of cash transfers on maternal health, [29,30] maternal mental health, [31] neonatal and infant mortality, [32,33] childhood malnutrition, [34,35] childhood vaccinations, [36,37] childhood illness, [38] childhood and adolescent education, [39,40] sexual and reproductive health practices of sex workers, mothers and adolescents, [41,42] geriatric health, [43] HIV incidence [44] and prevalence of high risk behavior for HIV, [45] and incidence of TB. [46] Only one study evaluated the impact of cash transfers on the uptake of surgical services, specifically C-sections in Mexico.…”

A scoping review of HIV epidemiologic, sociocultural and programmatic studies related to transgender women and men who have sex with men in Cambodia, 1999-2019

“…In terms of evaluation research, the above-mentioned study was the only solid effort found in this scoping review. This is surprising if one considers that large scale randomised trials have been conducted to assess HIV intervention effectiveness among Cambodian entertainment and sex workers, for example [57].…”

Adding quality to quantity in randomized controlled trials of addiction prevention and treatment: a new framework to facilitate the integration of qualitative research

“…For example, had the Cambodian CIPI trial proceeded to incentivize women to participate by offering US$1 for a urine screening visit, suboptimal recruitment leading to insufficient power to show an effect of the intervention may have resulted. Under‐incentivizing CIPI participants also had the potential to result in sampling bias with only impoverished women enrolling in the trial, compromising external validity and leading to non‐generalizable findings .…”

“…Furthermore, they expressed concerns about directly observed urine specimen collection and emphasized the need for enjoyable, as well as educational, content in the after‐care programme. Revisions to the protocol were subsequently made to optimize both the acceptability of the intervention and the implementation of the trial …”