Optimizing Cervical Cancer Screening Strategies With HPV Testing Among Women Living With HIV in Cameroon: Feasibility, Acceptability, and Impact of a Single-visit Test and Treat Approach in a Hospital Center With an HPV Testing Platform

Status: Recruiting
Location: See location...
Intervention Type: Other
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Context. Cervical cancer (CC) is a leading cause of death among women living with HIV (WLHIV) in resource-limited settings. Yet, effective methods for screening and preventing CC are available. The recommanded approach for CC screening is based on multiple steps, including initial test to detect human papillomavirus (HPV) infection, visual inspection to identify women with HPV at risk for precancerous lesion and treatment when required. Dropout may occur at these different steps, compromising the success of the CC elimination strategy. Performing the all screening and treatment sequence in a single visit has been recommanded based on the results of a large South African trial. Yet, in many contexts, including those with limited resources, the screening and treatment activities are performed in multiple visites for logistical reasons, resulting in many dropouts. Strategies based on the differentiated prestation approaches, which propose a simplified management centered on the patients preferences, could guide the adaptation of the single-visit approach to account for contextual constraints while maintaining high effectiveness. The OptiTri-GC study aims to design and assess the impact of a differentiated CC screen and treat strategy in a district hospital; It will assess both its implementation and its effectiveness based on the completeness at each stage of the screening cascade. In addition, it will also include three sub-studies designed to evaluate : * The performance of urinary HPV testing. * The performance of different methods to identify women requiring a treatment. * The risk of post-treatment cervical disease. This study has two periods. During the first period, a single visit approach will be used while differentiated approach will be prepared using participatory research. During the second period, the differentiated approach will be implemented. The screening overall completeness will be compared between the two periods to assess the differentiated approach effectiveness. The study will also assess the implementation of each screening strategy in terms of : * Success through the measure of fidelity, reach and completeness * Identification of adaptation, barriers and facilitating/leverage factors * Perception, feasibility and acceptability of the screening strategies (by patients and health care workers) It will assess the participants' stress levels during the screening process and to identify potential psychosocial support strategies and document the experience of WLHIV and health workers during the screening process and the post-treatment follow-up. Other study objectives include : * To assess the performance of different methods to identify women requiring a treatment * To assess the performance of HPV testing on a urine sample compared with vaginal self-collected or cervical (clinician-collected) samples * To assess the efficacy of treatment in terms of post-treatment cervical lesions Methodology. Participants will be WLHIV aged 25 to 49 and eligible for CC screening. Health care workers will also be invited to participate to the implementation research. The data collected will be quantitative and qualitative.

Eligibility
Participation Requirements
Sex: Female
Minimum Age: 25
Maximum Age: 49
Healthy Volunteers: f
View:

• HIV infection

• receiving antiretroviral therapy

• living in the department of the study hospital

Locations
Other Locations
Cameroon
Foumban hospital
RECRUITING
Foumban
Contact Information
Primary
Andre-Pascal Goura, MD
cdpoptitri@gmail.com
+227679336464
Time Frame
Start Date: 2024-12-12
Estimated Completion Date: 2027-05
Participants
Target number of participants: 1422
Treatments
Active_comparator: Single visit
All women will be screened using a single-visit approach
Experimental: Differentiated prestation
A more flexible screening approach will be offered based on the participants preference. After counseling (following the decision aid approach), participants may decide to performed the screening in two visits.
Sponsors
Leads: Institut de Recherche pour le Developpement
Collaborators: Queen Mary University of London, Centre Pasteur du Cameroun, Institut National de la Santé Et de la Recherche Médicale, France, Ecole Polytechnique Fédérale de Lausanne, RSD Institute, Cameroon, Centre Hospitalier Simone Veil, Programme PACCI, Abidjan, Côte d'Ivoire, Hôpitaux Universitaire de Genève, International Agency for Research on Cancer

This content was sourced from clinicaltrials.gov