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Community-based accompaniment and psychosocial health outcomes in HIV-infected adults in Rwanda: a prospective study.
- Source :
-
AIDS and behavior [AIDS Behav] 2014 Feb; Vol. 18 (2), pp. 368-80. - Publication Year :
- 2014
-
Abstract
- We examined whether the addition of community-based accompaniment to Rwanda's national model for antiretroviral treatment (ART) was associated with greater improvements in patients' psychosocial health outcomes during the first year of therapy. We enrolled 610 HIV-infected adults with CD4 cell counts under 350 cells/μL initiating ART in one of two programs. Both programs provided ART and required patients to identify a treatment buddy per national protocols. Patients in one program additionally received nutritional and socioeconomic supplements, and daily home-visits by a community health worker ("accompagnateur") who provided social support and directly-observed ingestion of medication. The addition of community-based accompaniment was associated with an additional 44.3 % reduction in prevalence of depression, more than twice the gains in perceived physical and mental health quality of life, and increased perceived social support in the first year of treatment. Community-based accompaniment may represent an important intervention in HIV-infected populations with prevalent mental health morbidity.
- Subjects :
- Adult
CD4 Lymphocyte Count
Community Health Services organization & administration
Depression epidemiology
Directly Observed Therapy
HIV Infections psychology
Humans
Male
Middle Aged
Prevalence
Prospective Studies
Regression Analysis
Residence Characteristics
Rural Population
Rwanda epidemiology
Socioeconomic Factors
Treatment Outcome
Viral Load
Anti-HIV Agents therapeutic use
Community Health Workers
HIV Infections drug therapy
Medication Adherence
Social Support
Subjects
Details
- Language :
- English
- ISSN :
- 1573-3254
- Volume :
- 18
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- AIDS and behavior
- Publication Type :
- Academic Journal
- Accession number :
- 23443977
- Full Text :
- https://doi.org/10.1007/s10461-013-0431-2