Do peer support groups have an effect on medication adherence? A study among people living with HIV/AIDS in Enugu State, Nigeria

Chime, Onyinye Hope; Arinze-Onyia, Sussan U.; Obionu, Christopher N.

doi:10.1177/2010105818760923

Cited by 15 publications

(27 citation statements)

References 22 publications

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“…Our findings confirm previous studies in Senegal, West Africa and in Uganda who have reported a similar pattern among HIV-positive patients [15-31]. Although other studies have reported mixed results regarding the role of marital status [32, 33] on adherence, this situation may be explained by the fact that single patients may have access to better social support as they may only share their status with the medical staff for HIV antiretroviral therapy. For widowed HIV positive patients, HIV/AIDS represents a shame and they may fear discrimination and reject from the community who may already know their HIV status.…”

Section: Discussionsupporting

confidence: 90%

Prevalence and determinants of adherence to antiretroviral treatment among HIV patients on first-line regimen: a cross-sectional study in Dakar, Senegal

Mbengue¹,

Sarr²,

Diop³

et al. 2019

Pan Afr Med J

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Introduction Successful and long-term positive impact of antiretroviral treatment requires high rates of adherence (> 90%). In Senegal, there is a lack of data regarding adherence to antiretroviral treatment and only a few studies have looked at the determinants. The aim of this study is to assess the prevalence and determinants contributing to antiretroviral (ARV) adherence among Human Immunodeficiency Virus (HIV) infected outpatients receiving care at four public hospitals in Dakar, Senegal. Methods A cross-sectional based study was carried out among HIV-positive ART adults in Dakar, Senegal. Patients were systematically sampled during either their clinical visits or visit to collect ARV drugs from six public hospitals and data collected with a questionnaire. The study outcome was adherence to antiretroviral treatment assessed by a multiple approach method which combined three self-reported adherence tools: self-reporting, Visual Analog Scale (VAS), and the Simplified Medication Adherence Questionnaire (SMAQ). Data were entered with an Excel spreadsheet and transferred to STATA for descriptive, bivariate and multivariate analysis. All the statistical tests were done at the threshold level of 0.05. Results A total of 150 HIV-positive patients on first line ART regimen at six public health facilities were enrolled into the study. The mean age of patients was 43.1 years with a sex ratio of 0.3. Most of the patients were prescribed Tenofovir-based regimen. Of these patients, 26.67% were found to be highly adherent. After adjusting for health-related variables, demographic and socio-economic variables, better adherence was associated with participating actively within an association of persons living with HIV (AoR=2.89; 95% CI: 1.04 - 7.99; p value 0.041) while being widowed patient was associated with lower adherence (AoR=0.17; 95% CI: 0.03 - 0.94; p value 0.043). Conclusion Our study findings imply that adherence should be routinely assessed during medical visits. Ongoing strategies to improve adherence such as out-of-clinic group-based models or psychological support should be directed toward outpatients' clinics to assist in improving adherence and long term virologic suppression in Senegal.

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Section: Discussionsupporting

confidence: 90%

Prevalence and determinants of adherence to antiretroviral treatment among HIV patients on first-line regimen: a cross-sectional study in Dakar, Senegal

Mbengue¹,

Sarr²,

Diop³

et al. 2019

Pan Afr Med J

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“…Measurements of adherence based on participant's self-reports over 28 days are open to recall bias. Peer support groups were formal meetings of PLHIV aged 18 or over, where discussions centred on identifying barriers to adherence and problem-solving solutions [59].…”

Section: General Adult Populationsmentioning

confidence: 99%

A Cascade of Interventions to Promote Adherence to Antiretroviral Therapy in African Countries

et al. 2020

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Purpose of Review We reviewed interventions to improve uptake and adherence to antiretroviral therapy (ART) in African countries in the Treat All era. Recent Findings ART initiation can be improved by facilitated rapid receipt of first prescription, including community-based linkage and point-of-care strategies, integration of HIV care into antenatal care and peer support for adolescents. For people living with HIV (PLHIV) on ART, scheduled SMS reminders, ongoing intensive counselling for those with viral non-suppression and economic incentives for the most deprived show promise. Adherence clubs should be promoted, being no less effective than facility-based care for stable patients. Tracing those lost to follow-up should be targeted to those who can be seen face-to-face by a peer worker. Summary Investment is needed to promote linkage to initiating ART and for differentiated approaches to counselling for youth and for those with identified suboptimal adherence. More evidence from within Africa is needed on cost-effective strategies to identify and support PLHIV at an increased risk of non-adherence across the treatment cascade.

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“…Studies that did not measure adherence as an outcome were excluded from the systematic review. Thirty-one journal articles met the inclusion criteria [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ] and were included in the systematic review. Figure 1 shows the flowchart of the systematic review process.…”

Section: Resultsmentioning

confidence: 99%

“…The study designs consisted of ten cohort studies [ 24 , 25 , 29 , 33 , 34 , 37 , 38 , 47 , 52 , 53 ], four pre-post studies [ 26 , 28 , 35 , 36 ], sixteen randomized controlled trials [ 27 , 31 , 32 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 48 , 49 , 50 , 51 , 54 ], and only one cross-sectional study [ 30 ].…”

Section: Resultsmentioning

confidence: 99%

Interventions to Improve Adherence to Antiretroviral Therapy (ART) in Sub-Saharan Africa: An Updated Systematic Review

Damulak

Suriani

Manaf

et al. 2021

IJERPH

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Optimal adherence to antiretroviral therapy (ART) remains the bedrock of effective therapy and management of human immunodeficiency virus (HIV). This systematic review examines the effect of interventions in improving ART adherence in sub-Saharan Africa (SSA), which bears the largest global burden of HIV infection. In accordance with PRISMA guidelines, and based on our inclusion and exclusion criteria, PUBMED, MEDLINE, and Google Scholar databases were searched for published studies on ART adherence interventions from 2010 to 2019. Thirty-one eligible studies published between 2010 to 2019 were identified, the categories of interventions were structural, behavioral, biological, cognitive, and combination. Study characteristics varied across design, intervention type, intervention setting, country, and outcome measurements. Many of the studies were behavioral interventions conducted in hospitals with more studies being randomized controlled trial (RCT) interventions. Despite the study variations, twenty-four studies recorded improvements. Notwithstanding, more quality studies such as RCTs should be conducted, especially among key affected populations (KAPs) to control transmission of resistant strains of the virus. Reliable objective measures of adherence should replace the conventional subjective self-report. Furthermore, long-term interventions with longer duration should be considered when evaluating the effectiveness of interventions.

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Do peer support groups have an effect on medication adherence? A study among people living with HIV/AIDS in Enugu State, Nigeria

Cited by 15 publications

References 22 publications

Prevalence and determinants of adherence to antiretroviral treatment among HIV patients on first-line regimen: a cross-sectional study in Dakar, Senegal

Prevalence and determinants of adherence to antiretroviral treatment among HIV patients on first-line regimen: a cross-sectional study in Dakar, Senegal

A Cascade of Interventions to Promote Adherence to Antiretroviral Therapy in African Countries

Interventions to Improve Adherence to Antiretroviral Therapy (ART) in Sub-Saharan Africa: An Updated Systematic Review

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