Using social networks to find people with undiagnosed HIV and reduce stigma
Site-randomized Trial of a Novel Social Network Recruitment Intervention to Locate More Undiagnosed Positive Cases of HIV, Increase HIV Testing Among Men, and Reduce HIV-related Stigma in South Africa (E-SNRHT South Africa)
NA · University of Illinois at Chicago · NCT06857071
This project will test whether asking adults newly diagnosed with HIV to recruit friends, family, and acquaintances can locate people with undiagnosed HIV and reduce HIV-related stigma among testing-avoidant adults in the Msunduzi region of KwaZulu-Natal.
Quick facts
| Phase | NA |
|---|---|
| Study type | Interventional |
| Enrollment | 2480 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University of Illinois at Chicago (other) |
| Locations | 1 site (Pietermaritzburg, KwaZulu-Natal) |
| Trial ID | NCT06857071 on ClinicalTrials.gov |
What this trial studies
This site-randomized trial assigns 32 Department of Health clinics in the Msunduzi region to either the expanded social network recruitment (E-SNRHT) intervention or to a control condition, with clinics stratified by urbanicity. Adults newly diagnosed with HIV at participating clinics are enrolled as "seeds" and, at intervention clinics only, receive brief education and are asked to recruit members of their expanded social networks (friends, family, acquaintances) who may benefit from HIV testing. Recruited network members are offered HIV testing and, if positive, referred to antiretroviral treatment and supportive services, while outcomes in control clinics follow standard recruitment and testing procedures. The trial measures newly identified cases, linkage to care, and changes in HIV-related stigma across participating clinics.
Who should consider this trial
Good fit: Ideal participants are adults (≥18) who live in the Msunduzi region, speak English or isiZulu, were newly diagnosed with HIV in the past two months at a participating clinic (and received a recruitment coupon), plus the friends or contacts they recruit for testing.
Not a fit: People under 18, those living outside the Msunduzi area, individuals already established in HIV care or recently tested, or those unwilling to involve social contacts are unlikely to benefit from this recruitment-focused approach.
Why it matters
Potential benefit: If successful, this approach could reach hard-to-reach people who avoid testing—including men—leading to more diagnoses, faster linkage to treatment, and reduced HIV-related stigma in communities.
How similar studies have performed: Peer-driven and social network recruitment approaches have previously increased HIV testing uptake, but using expanded non–risk networks specifically to reduce stigma and find testing-avoidant individuals is a relatively new adaptation with limited prior trial data.
Eligibility criteria
Show full inclusion / exclusion criteria
"Seeds" (i.e., initial participants in both study arms) will be recruited via referrals from clinics' standard of care HIV testing. To be eligible, seeds must have received a new HIV diagnosis from a study clinic in the last 2 months (i.e., they must be newly diagnosed with HIV infection \[NDH\]), and must have been given a study recruitment coupon by staff at one of these clinics. They will also be screened to ensure that they meet the following additional eligibility criteria: are ≥ 18 years old, are able to be interviewed in English or isiZulu (since over 95% of the population in the Msunduzi region speaks one or both of these languages), are able to give informed consent, and indicate that they reside in the Msunduzi region of KwaZulu-Natal, South Africa. Seeds in the intervention arm (i.e., recruited from intervention condition-assigned clinics) will be asked to recruit their expanded social network members who they think would benefit from testing for HIV. Network members will be eligible to participate if they have a recruitment coupon given to them by a study participant (i.e., if they were recruited by an intervention arm participant); are ≥ 18 years old; able to be interviewed in English or isiZulu; able to give informed consent; and reside in the Msunduzi region. Inclusion Criteria: * Has study recruitment coupon (from clinic or from intervention arm participant) * Is ≥ 18 years old * Is able to be interviewed in English or isiZulu * Is able to give informed consent * Resides in the Msunduzi region Exclusion Criteria: * Does not have study recruitment coupon (from clinic or from intervention arm participant) * Is \< 18 years old * Is not able to be interviewed in English or isiZulu * Is not able to give informed consent * Does not reside in the Msunduzi region
Where this trial is running
Pietermaritzburg, KwaZulu-Natal
- Centre for Community-based Research, Human Sciences Research Council — Pietermaritzburg, KwaZulu-Natal, South Africa (RECRUITING)
Study contacts
- Principal investigator: Leslie D. Williams, Ph.D. — University of Illinois at Chicago
- Study coordinator: Leslie D. Williams, Ph.D.
- Email: lesliedw@uic.edu
- Phone: 312-996-8820
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Undiagnosed HIV Infection, Populations That Are Reluctant to Test for HIV, Long-term Undiagnosed HIV Infection, Individuals With Newly-diagnosed HIV Infection, HIV-related Stigma, Access to HIV Testing, expanded social network recruitment, social network recruitment to HIV testing