Shinyanga

Shinyanga HIV Test & Treat Project

Objective

This project involves the clinical and socio-economic evaluation of various models of testing for HIV and decentralized HIV care in a Tanzanian rural setting: the HIV Test and Treat project (T&T). The T&T project is implemented in collaboration with the Diocese of Shinyanga and its final goal is to provide the Tanzanian government with model(s) for sustainable HIV service delivery in rural Tanzanian settings.

This T&T project aims at enhancing availability and access to HIV care in the Simiyu and Shinyanga regions in north-western Tanzania, actively reaching out to identify HIV patients, treating all those found to be positive and improving long-term linkages to care and adherence support for all HIV-infected clients, once diagnosed.


Description

AIGHD is responsible for multidisciplinary operational research evaluating the T&T interventions through clinical, economic, and social scientific research under responsibility of an international PI and the Tanzanian co-PI, as well as providing capacity building and technical assistance with respect to five laboratories responsible for diagnostics of the T&T Project.


Publications

Social science research publications

The social science component involves a PhD study looking into the social impact and sustainability of the T&T interventions from the perspective of both clients and health care providers. The main study objective is to identify social challenges and determinants of success of the T&T interventions. This is mostly qualitative research in various communities in Shinyanga and Simiyu, interviewing key informants, performing observatory research, qualitative and semi-quantitative surveys, focus group discussions with clients, their families, healthcare providers as well as community health workers in the context of the Diocese of Shinyanga.

 

Title: ‘It is not fashionable to suffer nowadays’: Community motivations to repeatedly participate in outreach HIV testing indicate UHC potential in Tanzania

Link: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0261408

Title: Beyond viral suppression: Quality of life among stable ART clients in a differentiated service delivery intervention in Tanzania

Link: https://pubmed.ncbi.nlm.nih.gov/34052956/

Posters and Oral Abstract Sessions:

Link: https://programme.aids2020.org/Abstract/AbstractList?abstractGrid-sort=AbstractPrefix-asc&abstractGrid-page=159

 

Clinical research Publications:

The clinical science component assesses the feasibility of a community-based HIV care model in terms of effectiveness in HIV case finding, linkage to and retention in care, all in the context of improving clinical outcomes. This component seeks to determine the impact of community engagement and HIV testing strategies on the proportion of estimated HIV positive populations in the catchment area of the project sites that know their HIV status (“the first 90”), to evaluate different methods of community-based HIV testing and linkage to care in terms of acceptability and effectiveness (defined as increased HIV testing uptake, increased HIV testing coverage, and successful linkage to care), as well as evaluate the impact of the T&T model on HIV-related morbidity and mortality and the impact of the decentralized care model assessing its effectiveness in terms of treatment adherence, viral suppression, and loss to follow-up.

 

Title: Protocol and Operational Procedures for the implementation of a Differentiated HIV Service Delivery Model in North-Western Tanzania

Link: https://ijhsir.ahsas-pgichd.org/index.php/ijhsir/article/view/88

Title: Community- and facility-based HIV testing interventions in northern Tanzania: Midterm results of Test & Treat Project

Link: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266870

Title: Quality of care in a differentiated HIV service delivery intervention in Tanzania: A mixed-methods study

Link: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265307

Title: The Shinyanga Patient: A Patient’s Journey through HIV Treatment Cascade in Rural Tanzania

Link: https://www.mdpi.com/1660-4601/18/16/8418

 

(Socio-) Economic Research Publications:

The (socio-)economic research component assesses the financial implications concerning scalability and integration within the current health system in Tanzania. This research assesses the impact of decentralized HIV service delivery (DSS) on both the costs and the quality of life of patients vis a vis the standard clinic-based care employing using various tools. It also compiled a comprehensive review of African studies conducted to explore the sustainability of decentralized HIV service delivery and the impact of the ART clubs interventions both from a patient and a providers perspective.

 

Title: Patient-incurred costs in a differentiated service delivery club intervention compared to standard clinical care in Northwest Tanzania

Link: https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.25760

Title: Evaluating the sustainability of differentiated service delivery interventions for stable ART clients in sub-Saharan Africa: a systematic review protocol

Link: https://bmjopen.bmj.com/content/10/1/e033156

Title: Exploring Sustainability in the Era of Differentiated HIV Service Delivery in Sub-Saharan Africa: A Systematic Review

Link: https://pubmed.ncbi.nlm.nih.gov/33770063/

Findings are communicated regularly to project stakeholders to maximize uptake of testing, ensure linkage to care and promote retention in care, and to understand any unintended consequences of the approach at any of the steps in the care cascade.


AIGHD Research Lead

PI – Prof. Anton Pozniak

Co-PI – Prof Sayoki Mfinanga

Research Coordinator: Prof. Tobias Rinke de Wit

 


Partners

NIMR, Prof Sayoki Mfinanga

GILEAD, Dr Dennis Israelski

CUAMM Project Implementation Lead, Veronica Censi

AIGHD Lead Clinical Research, Dr Sabine Hermans

AIGHD Lead Social Science, Prof Eileen Moyer and Dr Josien de Klerk

Diocesan Health Network Coordinator and focal person of Ngokolo HC, Dr Patrobas Katambi


Contact info

Marloes Nijboer (m.nijboer@aighd.org)


Funders

Gilead Sciences


Countries

Tanzania


Links

Social Science Research Publications:

Title: ‘It is not fashionable to suffer nowadays’: Community motivations to repeatedly participate in outreach HIV testing indicate UHC potential in Tanzania

Link: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0261408

Title: Beyond viral suppression: Quality of life among stable ART clients in a differentiated service delivery intervention in Tanzania

Link: https://pubmed.ncbi.nlm.nih.gov/34052956/

Posters and Oral Abstract Sessions:

Link: https://programme.aids2020.org/Abstract/AbstractList?abstractGrid-sort=AbstractPrefix-asc&abstractGrid-page=159

 

Clinical Research Publications:

Title: Protocol and Operational Procedures for the implementation of a Differentiated HIV Service Delivery Model in North-Western Tanzania

Link: https://ijhsir.ahsas-pgichd.org/index.php/ijhsir/article/view/88

Title: Community- and facility-based HIV testing interventions in northern Tanzania: Midterm results of Test & Treat Project

Link: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266870

Title: Quality of care in a differentiated HIV service delivery intervention in Tanzania: A mixed-methods study

Link: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265307

Title: The Shinyanga Patient: A Patient’s Journey through HIV Treatment Cascade in Rural Tanzania

Link: https://www.mdpi.com/1660-4601/18/16/8418

 

(Socio-) Eonomic Publications

Title: Patient-incurred costs in a differentiated service delivery club intervention compared to standard clinical care in Northwest Tanzania

Link: https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.25760

Title: Evaluating the sustainability of differentiated service delivery interventions for stable ART clients in sub-Saharan Africa: a systematic review protocol

Link: https://bmjopen.bmj.com/content/10/1/e033156

Title: Exploring Sustainability in the Era of Differentiated HIV Service Delivery in Sub-Saharan Africa: A Systematic Review

Link: https://pubmed.ncbi.nlm.nih.gov/33770063/