AIDS and Behavior

, Volume 20, Issue 9, pp 2110–2118 | Cite as

Delivering Prevention Interventions to People Living with HIV in Clinical Care Settings: Results of a Cluster Randomized Trial in Kenya, Namibia, and Tanzania

  • Pamela BachanasEmail author
  • Daniel Kidder
  • Amy Medley
  • Sherri L. Pals
  • Deborah Carpenter
  • Andrea Howard
  • Gretchen Antelman
  • Nicolas DeLuca
  • Odylia Muhenje
  • Muhsin Sheriff
  • Geoffrey Somi
  • Frieda Katuta
  • Peter Cherutich
  • Janet Moore
Original Paper


We conducted a group randomized trial to assess the feasibility and effectiveness of a multi-component, clinic-based HIV prevention intervention for HIV-positive patients attending clinical care in Namibia, Kenya, and Tanzania. Eighteen HIV care and treatment clinics (six per country) were randomly assigned to intervention or control arms. Approximately 200 sexually active clients from each clinic were enrolled and interviewed at baseline and 6- and 12-months post-intervention. Mixed model logistic regression with random effects for clinic and participant was used to assess the effectiveness of the intervention. Of 3522 HIV-positive patients enrolled, 3034 (86 %) completed a 12-month follow-up interview. Intervention participants were significantly more likely to report receiving provider-delivered messages on disclosure, partner testing, family planning, alcohol reduction, and consistent condom use compared to participants in comparison clinics. Participants in intervention clinics were less likely to report unprotected sex in the past 2 weeks (OR = 0.56, 95 % CI 0.32, 0.99) compared to participants in comparison clinics. In Tanzania, a higher percentage of participants in intervention clinics (17 %) reported using a highly effective method of contraception compared to participants in comparison clinics (10 %, OR = 2.25, 95 % CI 1.24, 4.10). This effect was not observed in Kenya or Namibia. HIV prevention services are feasible to implement as part of routine care and are associated with a self-reported decrease in unprotected sex. Further operational research is needed to identify strategies to address common operational challenges including staff turnover and large patient volumes.


HIV/AIDS Sub-Saharan Africa HIV prevention People living with HIV 


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Copyright information

© Springer Science+Business Media New York (outside the USA)  2016

Authors and Affiliations

  • Pamela Bachanas
    • 1
    Email author
  • Daniel Kidder
    • 1
  • Amy Medley
    • 1
  • Sherri L. Pals
    • 1
  • Deborah Carpenter
    • 2
  • Andrea Howard
    • 3
  • Gretchen Antelman
    • 4
  • Nicolas DeLuca
    • 5
  • Odylia Muhenje
    • 6
  • Muhsin Sheriff
    • 7
  • Geoffrey Somi
    • 8
  • Frieda Katuta
    • 9
  • Peter Cherutich
    • 10
  • Janet Moore
    • 1
  1. 1.Division of Global HIV/AIDSU.S. Centers for Disease Control and PreventionAtlantaUSA
  2. 2.Division of Global HIV/AIDSU.S. Centers for Disease Control and PreventionDar Es SalaamUnited Republic of Tanzania
  3. 3.ICAPColumbia UniversityNew YorkUSA
  4. 4.ICAP-TanzaniaColumbia UniversityDar Es SalaamUnited Republic of Tanzania
  5. 5.Division of Global HIV/AIDSU.S. Centers for Disease Control and PreventionWindhoekNamibia
  6. 6.Division of Global HIV/AIDSU.S. Centers for Disease Control and PreventionNairobiKenya
  7. 7.ICAP-KenyaColumbia UniversityNairobiKenya
  8. 8.Ministry of Health and Social WelfareDar Es SalaamUnited Republic of Tanzania
  9. 9.Ministry of Health and Social ServicesWindhoekNamibia
  10. 10.National AIDS/STD Control Programme (NASCOP)NairobiKenya

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