Conducting an ongoing HIV clinical trial during the COVID-19 pandemic in Uganda: a qualitative study of research team and participants’ experiences and lessons learnt

Abstract

ObjectiveTo explore the experiences and lessons learnt by the study team and participants of the Workplace-based HIV self-testing among Men trial during the COVID-19 pandemic in Uganda.DesignAn explorative qualitative study comprising two virtual focus group discussions (FGDs) with 12 trial team members and 32 in-depth participant interviews (N=44). Data were collected via telephone calls for in-depth interviews or Zoom for FGDs and manually analysed by inductive content analysis.SettingFourteen private security companies in two Uganda districts.ParticipantsMembers of the clinical trial study team, and men working in private security companies who undertook workplace-based HIV testing.ResultsThe key themes for participants experiences were: ‘challenges in accessing HIV treatment and care, and prevention services’, ‘misinformation’ and ‘difficulty participating in research activities’. The effects on HIV treatment and prevention resulted from; repercussions of the COVID-19 restrictions, participants fear of coinfection and negative experiences at health facilities. The difficulty in participating in research activities arose from: fear of infection with COVID-19 for the participants who tested HIV negative, transport difficulties, limited post-test psychosocial support and lack of support to initiate pre-exposure prophylaxis. The key study team reflections focused on the management of the clinical trial, effects of the local regulations and government policies and the need to adhere to ethical principles of research.ConclusionsFindings highlight the need to organise different forms of HIV support for persons living with HIV during a pandemic. Additionally, the national research regulators and ethics committees or review boards are strongly urged to develop policies and guidelines for the continuity of research and clinical trials in the event of future shocks. Furthermore, this study calls on the appropriate government agencies to ensure public and researchers’ preparedness through continuing education and support.Trial registration numberClinicaltrials.gov NCT04164433; Pre-results.

COVID-19 Burden on HIV Patients Attending Antiretroviral Therapy in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study

“…This finding is in agreement with the study done in Addis Ababa in Tikur Anbessa Specialized Hospital (TASH), Dessie town government, and private hospitals where older chronic patients were more likely to miss clinical appointments/visits (36,37). The result of another study in Uganda was also consistent with this finding that older people were more likely to miss ART and related services (19,38). In our findings, those who had formal education are more likely to have care and treatment services.…”

Linkage to care and treatment among men with reactive HIV self-tests after workplace-based testing in Uganda: A qualitative study

“…One limitation was the use of phone interviews for data collection, which made it impossible to observe non-verbal cues from participants during the interview. Additionally, the COVID-19 restrictions and lockdowns at the time did not allow us to understand some of the naturally occurring wider structural challenges in the men's lives, because it was an extraordinary situation ( 50 ). Additionally, the study did not include a cost-effective analysis of the strategies that facilitated linkage to care to help policymakers in decision making, this should be the next step.…”

Barriers and facilitators to oral PrEP uptake among high-risk men after HIV testing at workplaces in Uganda: a qualitative study

“…Information sessions were held at the workplace and men who met the criteria and were interested in participation agreed on a convenient day and time for the interview. But due to COVID-19 restrictions, interviews were carried out through telephone calls [ 37 ]. Participants were purposefully sampled to include high-risk men with HIV-negative test results from different employee ranks, and age categories (19–30, 31–40, 41–50).…”