Improving Retention of Community-recruited Participants in HIV Prevention Research Through Saturday Household Visits; Findings from the HPTN 071 (PopART) Study in South Africa.

Abstract

BackgroundIdentifying successful strategies to improve participant retention in longitudinal studies remains a challenge. In this study we evaluated whether non-traditional fieldworker shifts (after hours during the week and weekends) enhanced participant retention when compared to retention during traditional weekday shifts in the HPTN 071 (PopART) population cohort (PC). MethodsHPTN 071 (PopART) PC participants were recruited and followed up in their homes on an annual basis by research fieldworkers over a 3-4 year period. The average number of successful follow-up visits, where a PC participant was found and retained in the study, was calculated for each of 3 visit schedules (early weekday shift, late weekday shift, and Saturday shift), and standardized to account for variation in fieldwork shift duration. We used one-way univariate analysis of variance (ANOVA) to describe differences in mean-successful visits and 95% confidence intervals between the shift types.ResultsData on 16651 successful visits were included. Successful visit rates were higher when conducting Saturday visits (14.0; 95% CI: 11.3-16.6) compared to both regular (4.5; 95% CI: 3.7-5.3) and late weekday shifts (5.3; 95% CI: 4.7-5.8) overall and in all subgroup analyses (P<0.001). The successful visit rate was higher amongst women than men were during all shift types (3.2 vs. 1.3, p<0.001). Successful visit rates by shift type did not differ significantly by age, over time, by PC round or by community triplet. ConclusionThe number of people living with HIV continues to increase annually. High quality evidence from longitudinal studies remains critical for evaluating HIV prevention and treatment strategies. This study showed a significant benefit on participant retention through introduction of Saturday shifts for home visits and these data can make an important contribution to the emerging body of evidence for improving retention in longitudinal research. Trial registrationPopART was approved by the Stellenbosch University Health Research Ethics Committees (N12/11/074), London School of Hygiene and Tropical Medicine (6326) ethics committee and the Division of AIDS (DAIDS) (Protocol ID 11865). PopART was registered with ClinicalTrials.gov (registration number NCT01900977).

Predictors of participant retention in a community-based HIV prevention cohort: perspectives from the HPTN 071 (PopART) study

“…In addition, small tokens of appreciation were issued to participants upon completion of study activities. Participant-researcher relationships were established and sustained during the course of the study, and during the dissemination period after study completion (21). Extensive community engagement, involving communities and other key stakeholder (health services, community organizations, police services etc.)…”

Advances in HIV Eradication Strategies

“…Since the discovery of the virus in 1983, over 75 million people have been diagnosed with HIV infection and about 37 million have died from the resultant diseases, making AIDS one of the main diseases that threaten human health. 1 The emergence of combination antiretroviral therapy (cART) has significantly improved the survival rate of HIV patients, making HIV infection a manageable chronic disease. cART can effectively inhibit HIV replication and reduce the viral loads to an undetectable level in plasma.…”

“…Acquired immune deficiency syndrome (AIDS) is an infectious disease caused by human immunodeficiency virus (HIV). Since the discovery of the virus in 1983, over 75 million people have been diagnosed with HIV infection and about 37 million have died from the resultant diseases, making AIDS one of the main diseases that threaten human health 1 . The emergence of combination antiretroviral therapy (cART) has significantly improved the survival rate of HIV patients, making HIV infection a manageable chronic disease.…”