Parents and family members in the era of ART: evidence from Cambodia and Thailand

Knodel, John; Hak, Sochanny; Khuon, Chandore; So, Dane; McAndrew, John

doi:10.1080/09540121.2011.555741

Cited by 13 publications

(22 citation statements)

References 16 publications

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“…To encourage patients’ adherence to ART in sub-Saharan Africa, several approaches have been used: intensified adherence counselling, reminder alarms/calendars, daily or weekly mobile phone text messages, electronic pill devices, adherence clubs and the use of treatment supporters (also called treatment buddies or medicine companions)(Church et al, 2015; Hirnschall, Harries, Easterbrook, Doherty, & Ball, 2013; Knodel, Hak, Khuon, So, & McAndrew, 2011; Kunutsor et al, 2011; Mills et al, 2014; World Health Organisation, 2004). A randomised controlled trial in South Africa, which followed participants for two years, reported better adherence and ART outcomes in the arm that had treatment supporters than the arm without them (Nachega, Mills, & Schechter, 2010).…”

Section: Introductionmentioning

confidence: 99%

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

Nakamanya

Mayanja

Muhumuza

et al. 2018

Global Public Health

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Section: Introductionmentioning

confidence: 99%

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

Nakamanya

Mayanja

Muhumuza

et al. 2018

Global Public Health

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“…A meta-analysis review indicates that peer education programs in developing countries are moderately effective at improving behavioral outcomes but show no significant impact on biological outcomes [14]. On the other hand, in most Asian countries, where the HIV epidemic is in a concentrated stage targeting the high risk population such as injecting drug users (IDUs) and sex workers, the adherence support may pose different challenges [15]. Hence the impact of peer support in Asian countries on virologic failure has not been proven.…”

Section: Introductionmentioning

confidence: 99%

Impact of peer support on virologic failure in HIV-infected patients on antiretroviral therapy - a cluster randomized controlled trial in Vietnam

et al. 2016

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BackgroundThe effect of peer support on virologic and immunologic treatment outcomes among HIVinfected patients receiving antiretroviral therapy (ART) was assessed in a cluster randomized controlled trial in Vietnam.MethodsSeventy-one clusters (communes) were randomized in intervention or control, and a total of 640 patients initiating ART were enrolled. The intervention group received peer support with weekly home-visits. Both groups received first-line ART regimens according to the National Treatment Guidelines. Viral load (VL) (ExaVir™ Load) and CD4 counts were analyzed every 6 months. The primary endpoint was virologic failure (VL >1000 copies/ml). Patients were followed up for 24 months. Intention-to-treat analysis was used. Cluster longitudinal and survival analyses were used to study time to virologic failure and CD4 trends.ResultsOf 640 patients, 71% were males, mean age 32 years, 83% started with stavudine/lamivudine/nevirapine regimen. After a mean of 20.8 months, 78% completed the study, and the median CD4 increase was 286 cells/μl. Cumulative virologic failure risk was 7.2%. There was no significant difference between intervention and control groups in risk for and time to virologic failure and in CD4 trends. Risk factors for virologic failure were ART-non-naïve status [aHR 6.9;(95% CI 3.2–14.6); p < 0.01]; baseline VL ≥100,000 copies/ml [aHR 2.3;(95% CI 1.2–4.3); p < 0.05] and incomplete adherence (self-reported missing more than one dose during 24 months) [aHR 3.1;(95% CI 1.1–8.9); p < 0.05]. Risk factors associated with slower increase of CD4 counts were: baseline VL ≥100,000 copies/ml [adj.sq.Coeff (95% CI): −0.9 (−1.5;−0.3); p < 0.01] and baseline CD4 count <100 cells/μl [adj.sq.Coeff (95% CI): −5.7 (−6.3;−5.4); p < 0.01]. Having an HIV-infected family member was also significantly associated with gain in CD4 counts [adj.sq.Coeff (95% CI): 1.3 (0.8;1.9); p < 0.01].ConclusionThere was a low virologic failure risk during the first 2 years of ART follow-up in a rural low-income setting in Vietnam. Peer support did not show any impact on virologic and immunologic outcomes after 2 years of follow up.Trial registration NCT01433601.

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“…A study in Cambodia and Thailand by Knodel et al concluded that family members commonly help with the ART treatment regimens of the client, including reminding them to take medication, particularly when they live in the same household ( 30 ). Family members can also assist in reminding the client to attend clinic appointments for collection of medication and may accompany them, a task often seen as complicated for a CCW ( 30 ). It is therefore not only in the best interest of the CCWs, but also the client, to ensure that these clients are well supported by their social support system.…”

Section: Discussionmentioning

confidence: 99%

Needs assessment for home-based care and the strengthening of social support networks: the role of community care workers in rural South Africa

Moshabela

Sips

Barten

2015

Global Health Action

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BackgroundCommunity care workers (CCWs) in rural South Africa provide medical, personal, household, educational, and social care services to their clients. However, little understanding exists on how provision of services is approached within a household, taking into account available social support networks.ObjectiveThe aim of this study was to generate an understanding of the processes that underpin the provision of care by CCWs in rural households and their engagement with clients, primary caregivers (PCGs), and other members of the social support network.DesignWe analysed in-depth interviews conducted in a triad of participants involved in a home-based care (HBC) encounter – 32 clients, 32 PCGs, and 17 CCWs. For each triad, a purposefully selected CCW was linked with a purposefully selected client and the corresponding PCG using maximum variation sampling. Three coders used an inductive content analysis method to describe participants’ references to the nuances of processes followed by CCWs in servicing HBC clients. Written informed consent was obtained from all participants.FindingsThe results suggest that, by intuition and prior knowledge, CCWs treated each household uniquely, depending on the clients’ care needs, cooperation, availability of a social network, and the reliability and resilience of the social support system for the client. Four distinct processes took place in rural households: needs assessment for care, rationing of care, appraisal of care, and reinforcement of a social support system. However, there was no particular order or sequence established for these processes, and caregivers followed no prescribed or shared standards.ConclusionsCCWs bring a basket of services to a household, but engage in a constant, dynamic, and cyclical process of weighing needs against services provided. The service package is uniquely crafted and tailored for each household, depending on the absorptive capacity of the social support network available to the client, and preferences of the clients remain central to the process of negotiating care.

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Parents and family members in the era of ART: evidence from Cambodia and Thailand

Cited by 13 publications

References 16 publications

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

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

Impact of peer support on virologic failure in HIV-infected patients on antiretroviral therapy - a cluster randomized controlled trial in Vietnam

Needs assessment for home-based care and the strengthening of social support networks: the role of community care workers in rural South Africa

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