Expanding Medication-Assisted Therapies in Central Asia

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorYale University

About this trial

Central Asia (CA) represents the most rapidly growing HIV epidemic region worldwide, concentrated in people who inject drugs (PWID) and their sexual partners, and scaling up opioid agonist therapies (OAT) in this region is the most cost-effective strategy to prevent new HIV infections, and more effective when combined with antiretroviral therapy (ART). The investigators propose to use the Network for the Improvement of Addiction Treatment (NIATx) implementation strategy to scale-up OAT in three diverse Central Asian countries (Kazakhstan, Kyrgyzstan, Tajikistan) and guided by the Exploration-Planning-Implementation-Sustainment (EPIS) framework. Understanding the trajectories of implementation and scale-up in this context may emerge through creating communities of practice, especially when cohesion and competence evolves, and may guide other healthcare delivery challenges in the region (e.g., HIV, TB); as well as build important regional expertise and understanding implementation trajectories should help support OAT program sustainability.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Quantitative surveys for PWID

18 years or older

Meeting DSM-V criteria for opioid dependence

Be either treatment naïve and seeking OAT or be on OAT for < 90 days

Disqualifiers

Not willing to provide consent

Trial design

Design model

Single group

Treatments tested in this trial

  • NIATx

    Behavioral

    For each country, the learning collaborative will be comprised of a Chief Narcologist from each region where the investigators will initially train them and the coaches using all the tools from the NIATx Academy (2-3-day training). The national coach for each country will receive ongoing and in-depth coaching from a US-based super coach. A nationwide Nominal Group Technique (NGT) will be conducted to assess barriers and potential targets to guide decision-making about changes. At the end of the initial meeting, each Chief Narcologist (CN) will be able to identify a change target for Plan, Do, Study, Act (PDSA) (entry, retention) and create a Change Project Form to state what will be done (e.g. flowcharting), who is involved (team), what are the measures and timeframe (\<4 weeks).

Treatment groups

900 Participants
are divided into 1 treatment group
Group A: NIATx ModelOther 1 intervention

Trial outcomes

Primary outcomes

1

OAT Census

Absolute number of patients on OAT per country

Time frame
36 months
2

OAT Census per Oblast

Absolute number of patients on OAT per oblast

Time frame
36 months

Secondary outcomes

1

New Patients

Total number of newly enrolled patients into OAT services, per country

Time frame
36 months
2

New Patients per Oblast

Total number of newly enrolled patients into OAT services, per oblast

Time frame
36 months
3

Dropout

Total number of patients dropping out of OAT services, per country

Time frame
36 months
4

Dropout per Oblast

Total number of patients dropping out of OAT services, per oblast

Time frame
36 months

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Yale University

Lead sponsor

Den Sooluk Nuru

Collaborator

Institute for International Health and Education

Collaborator

Global Health Research Center of Central Asia

Collaborator

National Institute on Drug Abuse (NIDA)

Collaborator