ENGAGEMENT IN HIV CARE (EHC)

The fast shifting epidemic of HIV cases in the Philippines is especially concentrated among men who have sex with other males (MSM) and among transwomen who have sex with other males (TSM). However, little is known about the barriers and facilitators that Filipinos living with HIV face throughout the HIV care continuum. The EHC project takes a look at those factors that promote or inhibit starting HIV treatment as well as those factors that make it easy or hard to stay in treatment. Better understanding of local contextual factors, including experiences with health care workers, can create an enabling environment for prevention and for HIV care.

survey QUESTIONNAIRE

Prospective participants are invited into the study during clinic visits or the clinics’ usual outreach efforts. The 30-minute survey is a face-to-face questionnaire guided by a health care worker. It asks about adherence to HIV treatment, missed appointments, difficulties of accessing care, disclosure of HIV status as well as mental health.

in-depth interview

Immediately after the survey, participants are invited into a 60-90 minute in-depth, one-to-one discussion with the health care worker. This talk explores two overarching topics: (a) experiences of navigating the health care system; and (b) perceptions or attitudes about strategies for improving engagement in HIV care programs.

chart review

With consent from the participant, the health care worker reviews the medical records of the participant. This review confirms the HIV status of the participant and gathers clinical outcome data, such as viral load and CD4 count, number of missed appointments, date of last appointment, and others. This is done without the participant present.

PROJECT DETAILS

Official Title. Developing strategies to promote engagement in HIV care among high-risk populations in the Philippines

Common Title. Engagement in HIV care (EHC)

Principal Investigator. Ronald Del Castillo, PsyD, MPH

Project Status. Ongoing (data collection complete; data analysis in process)

Ethics Approval and Registration. 2017-258-01 (UP Manila Research Ethics Board), 2016-1103 (UP Manila Research Grants Administration Office), 2nd floor Paz Mendoza Building, College of Medicine, University of the Philippines, Manila, 547 Pedro Gil Street, Ermita, 1000 Manila; telephone: +63 2 526 4346, mobile: +63 (92) 7236 4910, email: upmreb@post.upm.edu.ph

Basic Eligibility. HIV-positive Filipino/as are eligible. Participants are men who have sex with other males (MSM; born and identify as male) or transwomen who have sex with other males (TSM; born male but identify as female). They must also be 18 years old or older and have a command of Filipino, Taglish, or basic English.

Possible Risks. All research involve risk. Potential risks associated with participation in the project are unlikely, of low risk, and considered transient. Participants might feel uncomfortable answering questions about sexuality, sexual behavior, HIV status as well as other potentially sensitive topics. This might lead to psychological distress but is highly unlikely. The project includes a safety management plan, and interviewers are trained to support participants in distress.

Benefits. The potential direct individual benefits to participants are minimal and are limited to the overarching benefit to the population as a whole. The survey might lead to self-reflection about their own health, behaviors, and community. Bringing these issues to awareness might lead to new information or knowledge.

Incentive or Compensation. Participants are provided with limited compensation for possible transportation costs, loss wages, or other costs linked to their participation. They receive cash for completing the survey (P196) and additional cash for completing the in-depth interview (P294). They get an additional incentive (P100) for referring peers (up to 3) who are eligible and successfully enroll in the project - for an additional P300.

Commitment. This a 12-month project, with data collection for 6 months. The survey is about 30 minutes; and the in-depth interview, 60-90 minutes. A health care worker separately completes the chart review.

Location(s). The following clinics were involved:

  1. Taguig Social Hygiene Clinic, TND Village cor Col. P. Cruz St., Tuktukan, Taguig City

  2. Makati Social Hygiene Clinic, 7th floor, Makati City Hall Bldg., JP Rizal St., Makati City

  3. Pasay City Social Hygiene Clinic, Room 106, Pasay City Hall, FB Harrison St., Kalakhang Maynila

  4. Pinoy Plus, 965-B JRB Building, Anacleto Street, Sta. Cruz, Manila

  5. Sustained Health Initiatives of the Philippines, St. Patrick’s Healthcare Bldg., 566 Shaw Blvd., Mandaluyong City

Funding Source. Providence/Boston Center for AIDS Research

Project Contact. Closed