Social media secret Facebook groups for HIV pre-exposure prophylaxis awareness among female sex workers in Cameroon

ISRCTN	ISRCTN12278412
DOI	https://doi.org/10.1186/ISRCTN12278412

Submission date: 01/04/2023
Registration date: 24/04/2023
Last edited: 17/04/2023

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

Background and study aims
Female sex workers in Cameroon are at high risk of HIV infection and have low pre-exposure prophylaxis (PrEP) uptake and retention. This research leverages the increased use of social media among female sex workers in Cameroon to explore novel tools that could support ongoing HIV prevention efforts. The aim of this study is to evaluate the feasibility and acceptability of an intervention promoting health care literacy around HIV, PrEP, and stigma reduction using private social media groups that complemented existing HIV prevention services among female sex workers in Cameroon.

Who can participate?
Participants that self-identified as female sex workers, were members of the New Life Club, 18 years old or older, HIV negative, fluent in Pidgin English and owners of an Android phone with internet access. The study enrolled a total of 60 participants (40 in the intervention group and 20 in the control group) and was completed in March 2021.

What does the study involve?
The intervention was 12 HIV and sexual health videos developed by the study team and tailored to female sex workers, which were released over 8 weeks through a secret Facebook group platform. Outcomes were measured using in-person surveys that were administered before, after the intervention, and three months later.

What are the possible benefits and risks of participating?
The study intervention complemented existing HIV services by providing new information on PrEP, post-exposure prophylaxis, and sex work-related stigma through a safe space for online interaction with other female sex workers. Successful measures were taken to prevent the release of participants´ personal information.

Where is the study run from?
University of Alabama at Birmingham (USA)

When is the study starting and how long is it expected to run for?
October 2018 to May 2021

Who is funding the study?
Center for AIDS Research, University of Alabama at Birmingham (USA)

Who is the main contact?
Dr Laia J Vazquez Guillamet
laiavgll@gmail.com

Contact information

Dr Laia J Vazquez Guillamet
Scientific

Calle del Rossellón 132, 7th fl
Barcelona
08036
Spain

ORCID ID	0000-0002-2649-3910
Phone	+34 93 227 1806
Email	laia.vazquez@isglobal.org

Study information

Study design	Single-center group randomized cross over pilot study
Primary study design	Interventional
Secondary study design	Randomised cross over trial
Study setting(s)	Community
Study type	Prevention
Participant information sheet	Not available in web format, please use contact details to request participant information sheet
Scientific title	Randomized pilot study with cross-over model to assess the feasibility, acceptability, and potential of an intervention using secret Facebook groups to complement existing HIV prevention strategies among female sex workers in Cameroon
Study objectives	The purpose of this pilot study was to evaluate the feasibility and acceptability of a widely available social media group with privacy features promoting health care literacy among female sex workers in Cameroon, and its potential impact on reported interest in PrEP, confidence in PrEP knowledge, condom use, social cohesion, and stigma related to sex work, HIV and PrEP.
Ethics approval(s)	1. Approved 06/09/2019, Cameroon Baptist Convention Health Board (CBCHB) Institutional Review Board (IRB) (Baptist Centre, Nkwen, PO Box 1 Bamenda, Northwest Region; Tel: not available; cbchbirb@gmail.com), ref: IRB2019-16 2. Approved 05/07/2021, Institutional Review Board of the University of Alabama at Birmingham (Office of the Institutional Review Board for Human Use, 470 Administration Building, 701 20th Street South, Birmingham, AL 35294-0104, USA; +1 (0)205 934 3789; irb@uab.edu), ref: IRB-300004333
Health condition(s) or problem(s) studied	Prevention of HIV infection among female sex workers in the anglophone region of Cameroon
Intervention	The intervention was 12 HIV and sexual health videos tailored to female sex workers and recorded in Pidgin English that were released over 8 weeks through a secret Facebook group platform. The first video introduced the project and explained the behavioral norms of the secret Facebook group. The other videos specifically talked about HIV, pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), condom use, sex work information from around the globe, and sex work-related stigma. The content was developed by the study team and recorded by the New Life Club coordinators in Pidgin English. In-person surveys were administered before, after the intervention, and three months later. The study survey was designed by the study team after a careful review of the existing literature, adapting validated and non-validated questionnaires used in prior studies (Hanoeman, 2017; Hargreaves, 2013; Lippman, 2010; Vazquez, 2019). The survey was piloted on a small number of NLC members; it lasted on average 10 minutes and was administered in-person by the study coordinators in a private environment.
Intervention type	Behavioural
Primary outcome measure	1. Project feasibility: measured as project retention (number of surveys completed at 3 and 6 months) 2. Confidence in PrEP knowledge: measured using the answer to the question “How is your knowledge about PrEP? (Very poor, Poor, Fair, Good, Excellent) measured before, after the intervention, and three months later
Secondary outcome measures	Surveys were administered before, after the intervention, and 3 months later: 1. Project acceptability: measured using the answer to the question “Would you recommend this project to a coworker?“ (Strongly disagree, Disagree, Undecided, Agree, Strongly agree) 2. Interest in PrEP: measured using the answer to the question ‘Are you interested in taking PrEP?’ (Strongly disagree, Disagree, Undecided, Agree, Strongly agree) 3. Condom use: measured using the answer to the question “How often do you use condoms? (Never, Less than half of the time, Half of the time, More than half of the time, Always) 4. PrEP-associated stigma: measured using the answer to the question “If you were taking PrEP would it cause you shame? (Strongly disagree, Disagree, Undecided, Agree, Strongly agree) 5. Sex work associated stigma: measured using the answer to the question “Does your work cause you to feel bad about yourself?“ (Strongly disagree, Disagree, Undecided, Agree, Strongly agree) 6. HIV-associated stigma: measured using the answer to the question “If you were taking PrEP, would you be worried about others mistaking you as HIV positive?“ (Strongly disagree, Disagree, Undecided, Agree, Strongly agree) 7. Social cohesion: measured using the answer to the question: “Can you count on other sex workers if you need to talk about your problems? (Strongly disagree, Disagree, Undecided, Agree, Strongly agree)
Overall study start date	01/10/2018
Completion date	25/05/2021

Eligibility

Participant type(s)	Healthy volunteer
Age group	Adult
Lower age limit	18 Years
Sex	Female
Target number of participants	80
Total final enrolment	60
Key inclusion criteria	1. Self-identified as female sex worker, 2. Member of the organization New Life Club 3. 18 years old and older 4. HIV negative (documented within 3 months prior to enrollment) 5. Fluency in Pidgin English (the local primary language used widely) The New Life Club (NLC) program is an initiative from the Cameroon Baptist Convention Health Board, hosted the study intervention. The NLC is a faith-based non-governmental organization with the purpose of assisting female sex workers in the Anglophone regions of Cameroon by promoting health resources and services.
Key exclusion criteria	1. Not owner of an android phone with internet access 2. Insufficient literacy level to interact in the group-chat
Date of first enrolment	01/10/2020
Date of final enrolment	23/10/2020

Locations

Countries of recruitment

Cameroon

Study participating centre

New Life Club

CBC Health Services Complex
Buea Road Mutengene
Mutengene
-
Cameroon

Sponsor information

University of Alabama at Birmingham
University/education

470 Administration Building
701 20th Street South
Birmingham, AL
35294-0104
United States of America

Phone	+1 205.934.3789
Email	irb@uab.edu
Website	http://www.uab.edu/
"ROR"	https://ror.org/008s83205

Cameroon Baptist Convention Health Services
Research organisation

Baptist Center
Nkwen, PO Box 1
Bamenda
-
Cameroon

Email	CBCHBIRB@gmail.com
Website	http://www.cbchealthservices.org/
"ROR"	https://ror.org/025fpk195

Funders

Funder type

University/education

Center for AIDS Research, University of Alabama at Birmingham
Government organisation / Research institutes and centers

Alternative name(s): Center for AIDS Research, University of Alabama at Birmingham, University of Alabama at Birmingham Center for AIDS Research, UAB Center for AIDS Research, Center for AIDS Research, CFAR at University of Alabama at Birmingham, CFAR, UAB CFAR
Location: United States of America

Results and Publications

Intention to publish date	01/05/2023
Individual participant data (IPD) Intention to share	Yes
IPD sharing plan summary	Stored in publicly available repository
Publication and dissemination plan	1. Preliminary results presented as poster at IDWeek 2021, San Diego, CA, USA. 2. Being prepared for peer-review submission to a journal
IPD sharing plan	The datasets generated during this study are stored in a publicly available repository: https://doi.org/10.6084/m9.figshare.20220102.v2

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Abstract results		04/12/2021	03/04/2023	No	No
Dataset		03/07/2022	17/04/2023	No	No

Editorial Notes

17/04/2023: Trial's existence confirmed by the University of Birmingham in Alabama (UAB).