Randomised trial of human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention in Zimbabwean youths

ISRCTN ISRCTN70775692
DOI https://doi.org/10.1186/ISRCTN70775692
Secondary identifying numbers RO1 MH 65570
Submission date
06/04/2009
Registration date
12/05/2009
Last edited
12/05/2009
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Infections and Infestations
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Frances Cowan
Scientific

Centre for Sexual Health and HIV Research
The Mortimer Market Centre
Off Capper Street
London
WC1E 6AU
United Kingdom

Study information

Study designCluster randomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Other
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleThe Regai Dzive Shiri Project: a cluster randomised controlled trial to determine the effectiveness of a multi-component community-based human immunodeficiency virus (HIV) prevention intervention for rural youths in Zimbabwe
Study acronymThe Regai Dzive Shiri Project
Study objectivesA community-based intervention targeting young people, adults and clinics will be effective in reducing rates of human immunodeficiency virus (HIV), herpes simplex virus type 2 (HSV-2) and pregnancy among young people in rural Zimbabwe.
Ethics approval(s)1. University College London (UCL) Ethics Committee approved on the 5th November 2002 (ref: 02/0140)
2. Medical Research Council of Zimbabwe approved on the 22nd October 2002 (ref: MRCZ/a/983)
3. London School of Hygiene and Tropical Medicine Ethics Committee approved on the 10th September 2002 (ref: 891)
Health condition(s) or problem(s) studiedHIV prevention and reproductive health
InterventionThe intervention is theoretically based in social learning theory and the stages of change model. It aims to achieve change in societal norms within communities. The intervention has three components:
1. The youth programme for in- and out-of-school youths, is delivered by carefully selected and trained Zimbabwean school leavers in the year between leaving school and starting university. These school leavers work as volunteers and go to live and work in the rural communities for 8 - 10 months of the year. They act both as role models for young people and as a bridge between adults and youths within communities. These professional peer educators (PPEs) use well-structured, theoretically based materials which they deliver in a highly participatory way. The programme is delivered to all students and out-of-school youths who wanted to take part and not just those enrolled in the trial cohort.
2. The programme for parents and community stakeholders is a 22 session community-based programme that aims to improve knowledge about reproductive health, to improve communication between parents and their children and to improve community support for adolescent reproductive health. The community component arose from focus group discussions held with parents during the feasibility study. Parents lamented the collapse of traditional communication structures and acknowledged their lack of communication skills. Interestingly young people also said that they struggled to communicate with their parents especially about reproductive health issues and that they saw this as an important barrier to staying safe.
3. The programme for nurses and other staff working in rural health clinics aims to improve accessibility of clinics for out-of-school youth.

These three components are highly integrated. For example, nurses trained to run the clinic intervention also run sessions within the youth and parents programmes and in so doing publicise the accessibility of the clinic. PPEs help run the 'youth corners' at the clinics and help facilitate sessions in the parents programme. Integrating the three components in this way makes them mutually supportive and reinforcing. By living and working so closely with the community it is hypothesised that the PPEs are able to change the norms of that community through challenging the norms that may be detrimental to adolescent reproductive health and reinforcing those that are beneficial.

No specific intervention was introduced in the deferred intervention arm, but standard HIV prevention activities were implemented through the District AIDS Action Committees by local and international governmental and non-governmental organisations across both early and deferred intervention communities. The project provided voluntary HIV counselling and testing through rural health clinics in all 30 communities on one day a month for the duration of the study. Uptake and acceptability was recorded.

The intervention was introduced in 2003 in the early implementation arm and in 2007 in the delayed implementation arm. The intervention ran in the early implementation arm for four years from 2003 - 2007. The final evaluation survey was conducted in 2007 after 4 years of intervention delivery. The final evaluation survey was a representative population based survey of 18 - 22 year olds living in six purposively selected enumeration areas in the 30 study communities - i.e., 180 enumeration areas in all.
Intervention typeOther
Primary outcome measure1. HIV prevalence
2. HSV-2 prevalence

Measured in 2007 after 4 years of intervention delivery.
Secondary outcome measures1. Pregnancy
2. Reported sexual behaviour
3. Knowledge and attitudes related to HIV acquisition and reproductive health

Measured in 2007 after 4 years of intervention delivery.
Overall study start date31/03/2003
Completion date31/07/2007

Eligibility

Participant type(s)Patient
Age groupOther
SexBoth
Target number of participantsIntervention recipients n = 12,000 - 16,000; final evaluation survey n = 6,000
Key inclusion criteria1. For intervention: young people (aged 12 - 24 years, either sex) living in 15 early intervention implementation trial communities
2. For participation in final evaluation survey: all 18 - 22 year olds living in selected enumeration areas in trial communities
Key exclusion criteriaDoes not meet inclusion criteria
Date of first enrolment31/03/2003
Date of final enrolment31/07/2007

Locations

Countries of recruitment

  • England
  • United Kingdom
  • Zimbabwe

Study participating centre

Centre for Sexual Health and HIV Research
London
WC1E 6AU
United Kingdom

Sponsor information

University College London (UCL) (UK)
University/education

Gower Street
London
WC1E 6JD
England
United Kingdom

Phone +44 (0)20 7380 9878
Email francesmcowan@yahoo.co.uk
Website http://ucl.ac.uk
ROR logo "ROR" https://ror.org/02jx3x895

Funders

Funder type

Government

National Institute of Mental Health (NIMH) (USA) (ref: RO1 MH-65570-01 and RO1 MH-65570-4S)
Government organisation / National government
Alternative name(s)
Instituto Nacional de la Salud Mental, Mental Health NIMH, NIMH
Location
United States of America

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article study design and baseline results 01/10/2008 Yes No