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Treatment partners and adherence to HAART in Central Mozambique
Adherence to highly active antiretroviral treatment (HAART) has been associated with increased survival rates and decreased drug resistance in various settings. There is growing concern that loss to follow-up will increase and adherence rates will decrease as HAART programs are expanded in resource-...
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| Published in: | AIDS care 2009-11, Vol.21 (11), p.1412-1419 |
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| Main Authors: | , , , , |
| Format: | Article |
| Language: | English |
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| cited_by | cdi_FETCH-LOGICAL-c489t-11e09bd95be61b1bcbe9ec7c49b512960d2e3d218ebc526bf0123b6f019231bf3 |
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| cites | cdi_FETCH-LOGICAL-c489t-11e09bd95be61b1bcbe9ec7c49b512960d2e3d218ebc526bf0123b6f019231bf3 |
| container_end_page | 1419 |
| container_issue | 11 |
| container_start_page | 1412 |
| container_title | AIDS care |
| container_volume | 21 |
| creator | Stubbs, B.A. Micek, M.A. Pfeiffer, J.T. Montoya, P. Gloyd, S. |
| description | Adherence to highly active antiretroviral treatment (HAART) has been associated with increased survival rates and decreased drug resistance in various settings. There is growing concern that loss to follow-up will increase and adherence rates will decrease as HAART programs are expanded in resource-limited settings. In Central Mozambique, an innovative program was implemented, using community-based (trained community activists) and self-selected (family members or friends) "treatment partners" to provide psycho-social support to patients on HAART. We calculated adherence rates based on pharmacy records for all patients who refilled their medication for at least six consecutive months between September 2004 and June 2006. Medical charts were reviewed for a subset of 375 patients having high (≥90%) adherence and 59 patients having low ( |
| doi_str_mv | 10.1080/09540120902814395 |
| format | article |
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There is growing concern that loss to follow-up will increase and adherence rates will decrease as HAART programs are expanded in resource-limited settings. In Central Mozambique, an innovative program was implemented, using community-based (trained community activists) and self-selected (family members or friends) "treatment partners" to provide psycho-social support to patients on HAART. We calculated adherence rates based on pharmacy records for all patients who refilled their medication for at least six consecutive months between September 2004 and June 2006. Medical charts were reviewed for a subset of 375 patients having high (≥90%) adherence and 59 patients having low (<90%) adherence. Multivariate logistic regression analysis assessed the association between the type of treatment partner used and adherence to HAART. A total of 305 patients (70%) had self-selected treatment partners, 121 (28%) had community-based treatment partners, and 8 (2%) had no treatment partner. In adjusted analysis, patients who had no treatment partner were more likely to have low adherence (OR 9.47; 95% confidence interval 2.37-37.86 compared to self-selected treatment partner). Patients with community-based treatment partners did not have significantly lower adherence than patients with self-selected treatment partners. While it cannot be determined from these data which aspects or types of peer support are most effective in maintaining adherence, it appears that peer support was beneficial to this study population. While the study results are not directly applicable to other populations, other HAART programs should consider the potential benefit of providing treatment support to patients.</description><identifier>ISSN: 0954-0121</identifier><identifier>EISSN: 1360-0451</identifier><identifier>DOI: 10.1080/09540120902814395</identifier><identifier>PMID: 20024718</identifier><identifier>CODEN: AIDCEF</identifier><language>eng</language><publisher>Abingdon: Taylor & Francis Group</publisher><subject>Acquired immune deficiency syndrome ; Activists ; Adherence ; Adolescent ; Adult ; Aged ; AIDS ; AIDS/HIV ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiretroviral drugs ; Antiretroviral therapy ; Antiretroviral Therapy, Highly Active ; Antiviral agents ; Biological and medical sciences ; Community based ; Confidence intervals ; developing countries ; Directly Observed Therapy ; Drug resistance ; Drug therapy ; Female ; HAART ; HIV Infections - drug therapy ; HIV/AIDS ; Humans ; Male ; Medical sciences ; Medication Adherence ; Mental health ; Middle Aged ; Mozambique ; Patient Acceptance of Health Care ; Pharmacology. Drug treatments ; Prevention. Health policy. Planification ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Regression Analysis ; Social psychiatry. Ethnopsychiatry ; Social Support ; Survival analysis ; Young Adult</subject><ispartof>AIDS care, 2009-11, Vol.21 (11), p.1412-1419</ispartof><rights>Copyright Taylor & Francis Group, LLC 2009</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Taylor & Francis Ltd. 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There is growing concern that loss to follow-up will increase and adherence rates will decrease as HAART programs are expanded in resource-limited settings. In Central Mozambique, an innovative program was implemented, using community-based (trained community activists) and self-selected (family members or friends) "treatment partners" to provide psycho-social support to patients on HAART. We calculated adherence rates based on pharmacy records for all patients who refilled their medication for at least six consecutive months between September 2004 and June 2006. Medical charts were reviewed for a subset of 375 patients having high (≥90%) adherence and 59 patients having low (<90%) adherence. Multivariate logistic regression analysis assessed the association between the type of treatment partner used and adherence to HAART. A total of 305 patients (70%) had self-selected treatment partners, 121 (28%) had community-based treatment partners, and 8 (2%) had no treatment partner. In adjusted analysis, patients who had no treatment partner were more likely to have low adherence (OR 9.47; 95% confidence interval 2.37-37.86 compared to self-selected treatment partner). Patients with community-based treatment partners did not have significantly lower adherence than patients with self-selected treatment partners. While it cannot be determined from these data which aspects or types of peer support are most effective in maintaining adherence, it appears that peer support was beneficial to this study population. While the study results are not directly applicable to other populations, other HAART programs should consider the potential benefit of providing treatment support to patients.</description><subject>Acquired immune deficiency syndrome</subject><subject>Activists</subject><subject>Adherence</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>AIDS</subject><subject>AIDS/HIV</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Antiviral agents</subject><subject>Biological and medical sciences</subject><subject>Community based</subject><subject>Confidence intervals</subject><subject>developing countries</subject><subject>Directly Observed Therapy</subject><subject>Drug resistance</subject><subject>Drug therapy</subject><subject>Female</subject><subject>HAART</subject><subject>HIV Infections - drug therapy</subject><subject>HIV/AIDS</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medication Adherence</subject><subject>Mental health</subject><subject>Middle Aged</subject><subject>Mozambique</subject><subject>Patient Acceptance of Health Care</subject><subject>Pharmacology. Drug treatments</subject><subject>Prevention. Health policy. Planification</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Regression Analysis</subject><subject>Social psychiatry. Ethnopsychiatry</subject><subject>Social Support</subject><subject>Survival analysis</subject><subject>Young Adult</subject><issn>0954-0121</issn><issn>1360-0451</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><sourceid>8BJ</sourceid><recordid>eNqF0VFrFDEQB_Agij1PP4AvsgitT1tnkt3sBoRyHGqFiiDnc0iys7hlNzmTPbR--qbeVcFifUogv_8kk2HsOcIpQguvQdUVIAcFvMVKqPoBW6CQUEJV40O2uDkvM8Aj9iSlSwDgIOExO-J5VzXYLtjZJpKZJ_JzsTVx9hRTYXxXmO4rRfKOijkU56vV500x-GKdXTRj8TH8NJMdvu3oKXvUmzHRs8O6ZF_evd2sz8uLT-8_rFcXpataNZeIBMp2qrYk0aJ1lhS5xlXK1siVhI6T6Di2ZF3Npe3zq4WVeVFcoO3Fkr3a193GkK9Ns56G5GgcjaewS7oRQrYIQmZ5cq-sM63lL_jyL3gZdtHnLjQHrDg2WS4Z7pGLIaVIvd7GYTLxSiPomyHoO0PImReHwjs7Ufc7cfvrGRwfgEnOjH003g3pj-PQSN5W2TV7N_g-xMl8D3Hs9GyuxhBvQ3eu1_OPOSff_Dcp_t3BNWGtsR4</recordid><startdate>200911</startdate><enddate>200911</enddate><creator>Stubbs, B.A.</creator><creator>Micek, M.A.</creator><creator>Pfeiffer, J.T.</creator><creator>Montoya, P.</creator><creator>Gloyd, S.</creator><general>Taylor & Francis Group</general><general>Taylor & Francis</general><general>Taylor & Francis Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7QL</scope><scope>7T2</scope><scope>7T7</scope><scope>7U9</scope><scope>8BJ</scope><scope>8FD</scope><scope>C1K</scope><scope>FQK</scope><scope>FR3</scope><scope>H94</scope><scope>JBE</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>200911</creationdate><title>Treatment partners and adherence to HAART in Central Mozambique</title><author>Stubbs, B.A. ; Micek, M.A. ; Pfeiffer, J.T. ; Montoya, P. ; Gloyd, S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-11e09bd95be61b1bcbe9ec7c49b512960d2e3d218ebc526bf0123b6f019231bf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Activists</topic><topic>Adherence</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>AIDS</topic><topic>AIDS/HIV</topic><topic>Antibiotics. 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Ethnopsychiatry</topic><topic>Social Support</topic><topic>Survival analysis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stubbs, B.A.</creatorcontrib><creatorcontrib>Micek, M.A.</creatorcontrib><creatorcontrib>Pfeiffer, J.T.</creatorcontrib><creatorcontrib>Montoya, P.</creatorcontrib><creatorcontrib>Gloyd, S.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>International Bibliography of the Social Sciences</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>AIDS care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stubbs, B.A.</au><au>Micek, M.A.</au><au>Pfeiffer, J.T.</au><au>Montoya, P.</au><au>Gloyd, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment partners and adherence to HAART in Central Mozambique</atitle><jtitle>AIDS care</jtitle><addtitle>AIDS Care</addtitle><date>2009-11</date><risdate>2009</risdate><volume>21</volume><issue>11</issue><spage>1412</spage><epage>1419</epage><pages>1412-1419</pages><issn>0954-0121</issn><eissn>1360-0451</eissn><coden>AIDCEF</coden><abstract>Adherence to highly active antiretroviral treatment (HAART) has been associated with increased survival rates and decreased drug resistance in various settings. There is growing concern that loss to follow-up will increase and adherence rates will decrease as HAART programs are expanded in resource-limited settings. In Central Mozambique, an innovative program was implemented, using community-based (trained community activists) and self-selected (family members or friends) "treatment partners" to provide psycho-social support to patients on HAART. We calculated adherence rates based on pharmacy records for all patients who refilled their medication for at least six consecutive months between September 2004 and June 2006. Medical charts were reviewed for a subset of 375 patients having high (≥90%) adherence and 59 patients having low (<90%) adherence. Multivariate logistic regression analysis assessed the association between the type of treatment partner used and adherence to HAART. A total of 305 patients (70%) had self-selected treatment partners, 121 (28%) had community-based treatment partners, and 8 (2%) had no treatment partner. In adjusted analysis, patients who had no treatment partner were more likely to have low adherence (OR 9.47; 95% confidence interval 2.37-37.86 compared to self-selected treatment partner). Patients with community-based treatment partners did not have significantly lower adherence than patients with self-selected treatment partners. While it cannot be determined from these data which aspects or types of peer support are most effective in maintaining adherence, it appears that peer support was beneficial to this study population. While the study results are not directly applicable to other populations, other HAART programs should consider the potential benefit of providing treatment support to patients.</abstract><cop>Abingdon</cop><pub>Taylor & Francis Group</pub><pmid>20024718</pmid><doi>10.1080/09540120902814395</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0954-0121 |
| ispartof | AIDS care, 2009-11, Vol.21 (11), p.1412-1419 |
| issn | 0954-0121 1360-0451 |
| language | eng |
| recordid | cdi_pascalfrancis_primary_22076284 |
| source | Applied Social Sciences Index & Abstracts (ASSIA); International Bibliography of the Social Sciences (IBSS); Taylor and Francis:Jisc Collections:Taylor and Francis Read and Publish Agreement 2024-2025:Medical Collection (Reading list) |
| subjects | Acquired immune deficiency syndrome Activists Adherence Adolescent Adult Aged AIDS AIDS/HIV Antibiotics. Antiinfectious agents. Antiparasitic agents Antiretroviral drugs Antiretroviral therapy Antiretroviral Therapy, Highly Active Antiviral agents Biological and medical sciences Community based Confidence intervals developing countries Directly Observed Therapy Drug resistance Drug therapy Female HAART HIV Infections - drug therapy HIV/AIDS Humans Male Medical sciences Medication Adherence Mental health Middle Aged Mozambique Patient Acceptance of Health Care Pharmacology. Drug treatments Prevention. Health policy. Planification Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Regression Analysis Social psychiatry. Ethnopsychiatry Social Support Survival analysis Young Adult |
| title | Treatment partners and adherence to HAART in Central Mozambique |
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