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A three-year randomized community trial of community support workers in rural Ethiopia to promote retention in HIV care.
- Source :
- AIDS Care; Dec2022, Vol. 34 Issue 12, p1506-1512, 7p, 1 Diagram, 3 Charts
- Publication Year :
- 2022
-
Abstract
- Retention in care is a major challenge for global AIDS control, including sub-Saharan Africa. In a large Ethiopian region, we evaluated an intervention where HIV positive community support workers (CSWs) provided HIV health education, personal counseling and social support for HIV patients new to care. We enrolled 1,799 patients recently entering care from 32 hospitals and health centers, randomized to intervention or control sites. Dates of all clinic visits, plus deaths or transfers were abstracted from HIV medical records. Primary outcomes were gap in clinical care (>90 days from a missed clinical or drug pickup appointment) and death. For 36 months of follow-up, and for the first 12 months after enrollment, weighted risk differences [RD] between treatment arms were modest and non-significant for gap in clinical care, death or either outcome. Through 36 months, 624 of 980 controls and 469 of 819 intervention participants had gaps in clinical care (RD = −5.5%, 95% confidence interval [CI] = −17.9%, 7.0%); 79 controls and 82 intervention participants died (RD = 2.5% 95% CI = −1.7%, 6.8%). Factors including HIV stigma and a volatile political climate may have attenuated the advantages we anticipated, demonstrating how benefits of CSW interventions may depend upon psychosocial, clinical and structural factors particular to specific community settings. [ABSTRACT FROM AUTHOR]
- Subjects :
- HIV infections & psychology
HIV infections
HEALTH education
ANTI-HIV agents
COUNSELING
SOCIAL support
EVALUATION of human services programs
CONFIDENCE intervals
RURAL conditions
PRACTICAL politics
COMMUNITY support
ACQUISITION of data
SOCIAL stigma
CONTINUUM of care
RANDOMIZED controlled trials
COMPARATIVE studies
MEDICAL records
DESCRIPTIVE statistics
DRUGS
PATIENT compliance
STATISTICAL sampling
MEDICAL appointments
HEALTH promotion
PSYCHOLOGY of HIV-positive persons
LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 09540121
- Volume :
- 34
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- AIDS Care
- Publication Type :
- Academic Journal
- Accession number :
- 160508560
- Full Text :
- https://doi.org/10.1080/09540121.2022.2029819