Are treatment supporters relevant in long-term Antiretroviral Therapy (ART) adherence? Experiences from a long-term ART cohort in Uganda

Abstract

Treatment supporters remain important in adherence to long-term ART. HIV-care providers need to encourage the involvement of a treatment supporter for individuals taking ART long-term.

What causes non-adherence among some individuals on long term antiretroviral therapy? Experiences of individuals with poor viral suppression in Uganda

“…In addition, HIV care medications including ART and cotrimoxazole were always in stock and people living with HIV were offered ART adherence health education. During the pre-ART initiation health education sessions, participants and their treatment supporters were prepared for ART initiation [42]. Continuous post ART initiation health education was offered to people living with HIV at every ART refill visit to encourage them to adopt safe sexual behaviours and adherence to ART.…”

The potential impact of the COVID-19 pandemic on HIV, tuberculosis, and malaria control in Africa: a systematic review of modelling studies and population surveys

“…The current crisis because of COVID-19 creates all the conditions that have been indicated in previous studies as being associated with HIV and TB treatment non-adherence and lost to follow across the continent. 25,49,[58][59][60][61][62][63][64][65][66][67] The cost-effectiveness of various innovative solutions for service delivery is well documented across the continent, 54,[68][69][70][71][72][73][74][75][76][77][78][79][80][81][82] warranting their utility to mitigate the risks posed by COVID-19 (Table 3); however, some constraints have been reported. In relation to mobile clinics, these include logistical challenges as well as spatial and structural constraints.…”

COVID-19-Compliant Strategies for Supporting Treatment Adherence Among People Living with HIV in Sub-Saharan Africa

“…Travel restrictions and social distancing may also disrupt the existing community-based ART delivery and psychosocial support strategies that mitigate the negative impacts of barriers to ART adherence (e.g., psychological distress, community stigma, and distance from health care centers) and provide effective ART uptake reminders to PLWH [12]. By impeding PLWH's ability access to ART medication at community venues or by preventing community health workers from making home visits to conduct health and social needs assessments and deliver ART medication [13][14][15][16][17], COVID-19 prevention efforts may come at the cost of PLWH's physical and psychosocial health.…”

“…Treatment supporters offer one cost-effective and COVID-19-compliant means of providing community-based ART adherence support and care for PLWHs. Nominated by patients or health care providers, treatment supporters are typically PLWH's confidantes (e.g., close relatives, parents, or partners) who have the moral authority to help them with ART management and provide psychosocial support [14][15][16]. A recent systematic review found that treatment supporter interventions in SSA significantly improved ART adherence and virologic suppression among adult PLWHs compared to the standard of care [16].…”

“…Their close relationships and at times cohabitation with PLWHs make them the most available, reliable, and convenient source of psychosocial support at a time when options for social contact remain limited. Additionally, treatment supporters are well positioned to support empowered living (i.e., having the necessary motivation, support, and knowledge to maintain optimal ART adherence, even in stressful situations [15]) among PLWHs by mitigating stress that may result from COVID-19 social control measures. To address PLWH's possible forgetfulness, treatment fatigue, and effects of psychological distress, treatment supporters may also assist by collecting and delivering medication, administering medication, and providing clinic attendance reminders [13,15].…”