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Table 1 Summary of research questions addressed within the ANRS 12249 TasP trial social research programme and triangulation of associated surveys and sub-studies

From: Addressing social issues in a universal HIV test and treat intervention trial (ANRS 12249 TasP) in South Africa: methods for appraisal

Key research areas Research questions Home-based survey Clinic-based survey Community qualitative study Costs assessment and time-motion survey Health care professionals survey
Community perceptions and experiences What are the community perceptions and experiences of the trial intervention package?    X   
How does the trial intervention package of HIV testing and care fit with community’s experience of Department of Health service provision?    X   
Can communities be successfully engaged in the trial intervention package, i.e. does community stigma towards PLWHIV decrease and social support improve over the duration of the trial? X X X   
HIV testing What are the individuals and community attitudes to and perceptions of HIV testing and repeat HIV testing, and do these change over the duration of the trial? X   X   
What are the social, economic and environmental barriers to initial and repeat home-based HIV testing, and do these change over duration of the trial? X   X   
What is the impact of repeat HIV testing on disclosure and conjugal relationships and do these change over the duration of the trial?      
Linkage to HIV care What are the social, economic and environmental barriers to entry into care and do these change over duration of the trial? X X X   
How acceptable to individuals and the community is the trial model of HIV care?   X X   
HIV care and treatment What are community and individual expectations, perceptions and knowledge of immediate ART over time? X X X   
What are the social, economic and environmental barriers to immediate ART and do these change over the duration of the trial?   X X   
What is the impact of immediate ART on adherence and retention in care and how does it changes over time?   X X   
What are the causal impacts of immediate ART for quality of life and patient satisfaction?   X    
What are the psycho-social impacts (disclosure status, union-break up, social support, perceived stigma, depression, gender-based violence) of immediate ART?   X X   
What are community and individual expectations, perceptions and knowledge of immediate ART and do these change over time? X X X   
Sexual behaviours and HIV risk/prevention practices What are the most common HIV sexual risk behaviours and practices (e.g. multiple concurrent partners)? X X    
What are the main prevention strategies (change in sexual practices, condom use, male circumcision) and do these changes over the duration of the trial? X X    
  What are the effects of immediate ART on sexual behaviours and HIV prevention practices? X X    
Economic impacts and economic value What is the causal impact of the trial intervention package on employment, household welfare and private health care spending? X X    
How does the trial intervention affect quality of care and health systems outcomes, such as impacts on health care professionals (training, working conditions, practices, perceptions) and health care capacity?      X
What are the cost and the cost-effectiveness of the trial intervention package (home-based testing, immediate ART) in this rural South African context? What is the full social net value of the trial intervention package? X X   X X
What is the feasibility and financial sustainability (budget impact) of the trial intervention package (health system level) in this rural South African context? X X   X X
  1. ART: antiretroviral therapy; DoH: department of health; PLWHIV: people living with HIV.