The comparison arm consisted only of risk network members of these seeds. It also asked participants to name risk network members in the following categories: people they injected drugs or had sex with in the past six months; people who injected or had sex in their presence in the past six months; and people who injected, used drugs or had sex with people with whom the participants had injected or had sex. If a PwRI was found in networks of seeds including those recruited through venues , the network members of this newly identified recently infected network member were recruited for two additional steps.
The dependent variable in the analyses was the proportion of network members in each study arm who were PwRI. Network members were tested for HIV. The number of nominated network members and of venue members whom our staff social worker recruited was not limited. Participants were provided with standard counselling and were actively linked to care if appropriate. Experienced medical workers conducted HIV rapid tests after the interview for all participants. A medical worker checked veins for signs of punctures. Only PWID with visible punctures were allowed to participate.
They were selected to make sure that the seeds selected from each city had unknown or negative HIV status and varied in terms of age and other important characteristics. Odessa IBBS had four seeds. Seeds were given three coupons to give to other PWID who could then take part in the study and receive compensation, as described below.
In other words, we used the more conservative Fisher's exact test to test the null hypothesis that each sample had equal proportions of recently infected persons as a way to deal with this issue of data sparseness Furthermore, since there was only one recently infected participant in IBBS, this sparse data problem meant that we could not compute meaningful confidence intervals for the odds ratios comparing the yields of TRIP and IBBS.
We thus used exact statistics to test the null hypothesis that each sample had equal proportions of recently infected persons.
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We therefore could not test for confounding with personal characteristics of participants. Prior to study enrolment, both seeds and secondary respondents were provided with comprehensive information about the study and signed a consent form. Participants in the two arms of the TRIP sample were generally similar. None of these MSM had recently been infected. The The Ukrainian currency was sharply devalued following the Maidan insurrection that ousted the President early in , the Russian occupation of Crimea, and the beginning of civil war in eastern Ukraine.
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Cost comparison a. This was also true when comparisons were restricted to PWID. These different results may well be due to the different percentages in the two cities of risk network members who were recruited from venues as opposed to from among named risk network members.
It seems likely that many of these venue recruits did not engage often, if at all, in risk behaviours with those who nominated their venues as places from which to recruit, so their probability of being recently infected would be likely to have a weaker relationship to the infection status of the seed or network member from whose venue they were recruited.
However, our sample size was unfortunately too small to let us test for a possible effect on PwRI recruitment rate of the interaction between recruitment type venue vs. This paper is subject to a number of limitations. This led to some participants incorrectly taking part more than once. Fifth, the seeds for both arms of TRIP were clients of the same community service organization, so their networks often overlapped. This may have contributed to making their yields of PwRI similar.
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Seventh, the fact that only one IBBS participant was recently infected created a problem of sparseness, which means that the accuracy of the magnitude of the odds ratios is limited. This same problem prevented adjusted analyses to control for confounding covariates. In both cases, the comparisons had significance levels below 0. As discussed above, PwRI are a strategically important target group for treatment as prevention. Locating people soon after they become infected is an important goal both for patient care and for HIV prevention.
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LDW Together with SRF, did most of the writing of the paper; helped conceptualize this paper; conducted most of the statistical analyses; contributed to TRIP field operations; helped resolve complex data issues; and approved the final version. AK Managed day to day TRIP field operations during much of the project; organized and maintained complex data files; helped conceptualize this paper; helped resolve complex data issues; contributed to the analyses; helped write the paper; and approved the final version.
PS Helped write the funding proposal; oversaw and contributed to all TRIP field operations; helped conceptualize this paper; conducted the analyses of costs; helped write the paper; and approved the final version. GKN Helped conceptualize this paper; helped design the analysis plan; helped write the paper; and approved the final version. BS Helped conceptualize this paper; helped write the paper; and approved the final version.
EM Helped conceptualize this paper; helped write the paper; and approved the final version. JS Helped write the proposal; helped conceptualize this paper; helped write the paper; and approved the final version. SC, VC. LK conducted the operations of the Odessa Regional Laboratory Center of the Ministry of Health of Ukraine which conducted the LAg analyses and provided other information that help determine which participants had recently been infected; approved the paper.
SRF Overall project principal investigator; oversaw all field operations in some detail; wrote funding proposal with help from PS, JS and TVY; led in conceptualizing and directing this paper; conducted some analyses; helped write the paper; approved the final version. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Williams L. National Center for Biotechnology Information , U. Published online Jun Author information Article notes Copyright and License information Disclaimer. Samuel R Friedman, Email: gro.
Corresponding author. Tel: 1 Received Nov 30; Accepted May Methods 2. TRIP methods 2. Find the graves of ancestors, create virtual memorials or add photos, virtual flowers and a note to a loved one's memorial.
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