Community adherence support improves programme retention in children on antiretroviral treatment: a multicentre cohort study in South Africa

Grimwood, Ashraf; Fatti, Geoffrey; Mothibi, Eula; Malahlela, Mokgadi; Shea, Jawaya; Eley, Brian

doi:10.7448/ias.15.2.17381

Cited by 75 publications

(80 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The effect of health worker towards HIV/ AIDS countermeasure behavior Path analysis result in the study showed that health worker support had direct and positive relations towards HIV countermeasure behavior, even though it was statistically insignificant. This was supported by the study done by Grimwood et al, (2012), that shows that supports from health worker will improve PLWHA health status.…”

Section: The Effect Of Family Supportmentioning

confidence: 66%

Path Analysis on the Factors Affecting People’s Behavior in HIV/AIDS Countermeasure on People Living with HIV/AIDS (PLWHA) in Solo Plus Peer Support Group, Surakarta

Adita

Demartoto

Pamungkasari

2017

J HEALTH PROMOT BEHAV

View full text Add to dashboard Cite

Background: HIV or Human Immunodeficiency Virus is a virus that infects white blood cells so the person's immunity declining thus causing it to become AIDS. HIV/AIDS countermeasure is far more effectively done by people living with HIV/AIDS (PLWHA) accompanied by good attitude and peer support, family, and health workers, Regional AIDS Countermeasure Commission, perceived behavioral control, and positive intention. The study aimed to analyze factors affecting the attitude in HIV/AIDS countermeasure on PLWHA in Solo Plus Peer Support Group (PSG) Surakarta with theory of planned behavior application. Subjects and Methods: The study design was analytic observational with cross sectional study approach. The location of the study was Solo Plus Peer Support Group Surakarta. Time of study was from January-February 2017. There was a total of 100 PLWHA as the sample, and the study employed purposive sampling technique. The dependent variable was the attitude towards HIV/AIDS countermeasure. The independent variables were the attitude, peer, family, health workers, Regional AIDS Countermeasure Commission support, perceived behavioral control and their intention. The variables were measured with questionnaires. Data analysis technique used was path analysis. Results: HIV/AIDS countermeasure attitude affected by intention(b=0.27; SE=0.10; p=0.012), peer support (b=0.26; SE=0.14, p= 0.066), AIDS Countermeasure Commission support (b=0.10; SE=0.10; p= 0.321), health workers support (b= 0.25, SE= 0.14, p= 0.073) and perceived behavioral control (b=0.23; SE=0.13; p=0.065). Intention affected by attitude (b=0.28; SE=0.15; p=0.059), peer support (b=0.29; SE= 0.13; p= 0.026), family support (b=0.16; SE=0.09, p= 0.090) and perceived behavioral control (b=0.21; SE= 0.11; p= 0.090). Conclusion: HIV/ AIDS countermeasure behavior was very much affected by the intention, peer support, AIDS Countermeasure Commission support, health worker support, and perceived behavioral control. Their intention was affected by attitude, peer support, family support, and perceived behavioral control.

show abstract

Section: The Effect Of Family Supportmentioning

confidence: 66%

Path Analysis on the Factors Affecting People’s Behavior in HIV/AIDS Countermeasure on People Living with HIV/AIDS (PLWHA) in Solo Plus Peer Support Group, Surakarta

Adita

Demartoto

Pamungkasari

2017

J HEALTH PROMOT BEHAV

View full text Add to dashboard Cite

show abstract

“…CBAS likely retains a larger pool of patients at increased risk of having unsuppressed viral loads by reducing mortality and LTFU amongst higherrisk children Grimwood et al, 2012). OT analyses are thus likely biased in the estimation of the true effect of CBAS on virological outcomes.…”

Section: Discussionmentioning

confidence: 99%

Improved virological suppression in children on antiretroviral treatment receiving community-based adherence support: A multicentre cohort study from South Africa

et al. 2013

Self Cite

View full text Add to dashboard Cite

Adherence to antiretroviral treatment (ART) is a challenge in childhood, and children on ART have reduced virological suppression compared to adults. This study evaluated the effect of community-based adherence support (CBAS) on virological outcomes amongst children receiving ART in four South African provinces. Patient Advocates are lay CBAS workers who provide adherence and psychosocial support for patients, undertaking home visits to address household challenges affecting adherence. Patient Advocates provide counselling for children's carers regarding adherence and psychosocial problems. A multicentre cohort study using routinely collected data was conducted at 57 public ART sites including ART-naive children (<16 years) starting ART. Virological suppression until four years of ART was compared between children who received and did not receive CBAS. Analyses were by intention-to-treat, controlling for confounding using multivariable generalised estimating equations. A total of 4853 children were included, of whom 982 (20.2%) received CBAS. The median baseline age was 6.3 years and the baseline CD4 cell percentage was 12.0%; both were equivalent between the two groups. CBAS children had more advanced baseline clinical disease (62.1% vs. 52.6% World Health Organisation stages III or IV; P < 0.0001). A total of 5908 viral load results were analysed. Virological suppression was 65.6% (95% confidence interval [CI]: 62.7-68.4%) vs. 55.5% (95% CI: 54.1-57.0%) in CBAS and non-CBAS children, respectively, at any time-point on treatment (P < 0.0001). In analyses controlling for baseline clinical, demographic, site-related variables and time on ART, children receiving CBAS were more likely to achieve virological suppression, adjusted odds ratio (aOR) 1.60 (95% CI: 1.35-1.89; P < 0.0001). The effect of CBAS increased in magnitude with increasing durations of ART, and CBAS particularly improved virological suppression in a higher-risk subgroup (children younger than two years, aOR 2.47 [95% CI: 1.59-3.84]). CBAS was associated with improved virological suppression in children receiving ART. Expanded implementation of this low-cost intervention should be considered in resource-poor settings.

show abstract

“…Furthermore, community adherence support has been shown to improve retention in care of children on ART in the SA public sector and should be considered for caregivers of children down-referred to community clinics on ART. [18] …”

Section: Discussionmentioning

confidence: 99%

Short-term outcomes of down-referral in provision of paediatric antiretroviral therapy at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa: A retrospective cohort study

et al. 2018

View full text Add to dashboard Cite

Background. The large scale-up of paediatric HIV care necessitated down-referral of many children receiving antiretroviral therapy (ART) from Red Cross War Memorial Children's Hospital (RCWMCH), Cape Town, South Africa. Few published data exist on the outcomes of these children. Objectives. To assess outcomes of children receiving ART in the first 12 months after down-referral to primary healthcare (PHC) clinics and identify determinants of successful down-referral. Methods. A retrospective cohort study of children <15 years of age who initiated ART at RCWMCH and were subsequently down-referred to one of two PHC clinics between January 2006 and December 2012 was completed. Baseline characteristics of patients and caregivers as well as CD4+ counts, viral loads (VLs) and weights were collected 6 and 12 months after down-referral. Outcomes included retention in care and viral suppression. Results. Of 116 children down-referred to the two study PHC clinics, 81.9% arrived at the designated PHC clinic and a further 8.6% continued care at other clinics, the remaining 9.5% being lost to follow-up. Of those successfully down-referred, 11.4% took >8 weeks to present, possibly experiencing treatment interruption. At 12 months after down-referral, only 81.0% remained in care. No factors were associated with retention in care in multivariable analysis. For children who remained in care at the designated PHC clinics, the clinical and immunological gains achieved prior to down-referral were sustained through 12 months of follow-up, and 54.7% of this cohort had documented viral suppression at 12 months. However, if only children with VL results are considered, 75.9% (41/54) were virally suppressed 12 months after down-referral. Conclusions. Down-referral of children on ART is complex, with risk of loss to follow-up and treatment interruption.

show abstract

Community adherence support improves programme retention in children on antiretroviral treatment: a multicentre cohort study in South Africa

Cited by 75 publications

References 25 publications

Path Analysis on the Factors Affecting People’s Behavior in HIV/AIDS Countermeasure on People Living with HIV/AIDS (PLWHA) in Solo Plus Peer Support Group, Surakarta

Path Analysis on the Factors Affecting People’s Behavior in HIV/AIDS Countermeasure on People Living with HIV/AIDS (PLWHA) in Solo Plus Peer Support Group, Surakarta

Improved virological suppression in children on antiretroviral treatment receiving community-based adherence support: A multicentre cohort study from South Africa

Short-term outcomes of down-referral in provision of paediatric antiretroviral therapy at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa: A retrospective cohort study

Contact Info

Product

Resources

About