BACKGROUND: As antiretroviral treatment cohorts continue to expand, ensuring patient retention over time is an increasingly important concern. This, together with capacity and human resource constraints, has led to the consideration of out-of-clinic models for the delivery of antiretroviral therapy (ART). In 2008, Médecins Sans Frontières and the Provincial authorities launched a model of ART distribution and adherence monitoring by community groups in Tete Province, Mozambique. PROGRAMME APPROACH: Patients who were stable on ART for 6 months were informed about the community ART group model and invited to form groups. Group members had 4 key functions: facilitate monthly ART distribution to other group members in the community, provide adherence and social support, monitor outcomes, and ensure each group member undergoes a clinical consultation at least once every 6 months. Group members visit the health centre on a rotational basis, such that each group member has contact with the health service every 6 months. RESULTS: Between February 2008 and May 2010, 1384 members were enrolled into 291 groups. Median follow-up time within a group was 12.9 months (IQR 8.5-14.1). During this time, 83 (6%) were transferred out, and of the 1301 patients still in community groups, 1269 (97.5%) were remaining in care, 30 (2%) had died, and 2 (0.2%) were lost to follow-up. DISCUSSION: The Community ART Group model was initiated by patients to improve access, patient retention, and decongest health services. Early outcomes are highly satisfactory in terms of mortality and retention in care, lending support to such out-of-clinic approaches.
BACKGROUND: As antiretroviral treatment cohorts continue to expand, ensuring patient retention over time is an increasingly important concern. This, together with capacity and human resource constraints, has led to the consideration of out-of-clinic models for the delivery of antiretroviral therapy (ART). In 2008, Médecins Sans Frontières and the Provincial authorities launched a model of ART distribution and adherence monitoring by community groups in Tete Province, Mozambique. PROGRAMME APPROACH: Patients who were stable on ART for 6 months were informed about the community ART group model and invited to form groups. Group members had 4 key functions: facilitate monthly ART distribution to other group members in the community, provide adherence and social support, monitor outcomes, and ensure each group member undergoes a clinical consultation at least once every 6 months. Group members visit the health centre on a rotational basis, such that each group member has contact with the health service every 6 months. RESULTS: Between February 2008 and May 2010, 1384 members were enrolled into 291 groups. Median follow-up time within a group was 12.9 months (IQR 8.5-14.1). During this time, 83 (6%) were transferred out, and of the 1301 patients still in community groups, 1269 (97.5%) were remaining in care, 30 (2%) had died, and 2 (0.2%) were lost to follow-up. DISCUSSION: The Community ART Group model was initiated by patients to improve access, patient retention, and decongest health services. Early outcomes are highly satisfactory in terms of mortality and retention in care, lending support to such out-of-clinic approaches.
Authors: Adedotun A Adetunji; Sufiyan A Muyibi; Martins Imhansoloeva; Olusola M Ibraheem; Adegbenga Sunmola; Olubunmi O Kolawole; Oluwasina O Akinrinsola; James O Ojo-Osagie; Olusola A Mosuro; Josephine O Abiolu; Achiaka E Irabor; Prosper Okonkwo; Isaac F Adewole; Babafemi O Taiwo Journal: AIDS Care Date: 2016-09-15
Authors: Barrot H Lambdin; Mark A Micek; Thomas D Koepsell; James P Hughes; Kenneth Sherr; James Pfeiffer; Marina Karagianis; Joseph Lara; Stephen S Gloyd; Andy Stergachis Journal: J Acquir Immune Defic Syndr Date: 2011-07-01 Impact factor: 3.731
Authors: Linda-Gail Bekker; George Alleyne; Stefan Baral; Javier Cepeda; Demetre Daskalakis; David Dowdy; Mark Dybul; Serge Eholie; Kene Esom; Geoff Garnett; Anna Grimsrud; James Hakim; Diane Havlir; Michael T Isbell; Leigh Johnson; Adeeba Kamarulzaman; Parastu Kasaie; Michel Kazatchkine; Nduku Kilonzo; Michael Klag; Marina Klein; Sharon R Lewin; Chewe Luo; Keletso Makofane; Natasha K Martin; Kenneth Mayer; Gregorio Millett; Ntobeko Ntusi; Loyce Pace; Carey Pike; Peter Piot; Anton Pozniak; Thomas C Quinn; Jurgen Rockstroh; Jirair Ratevosian; Owen Ryan; Serra Sippel; Bruno Spire; Agnes Soucat; Ann Starrs; Steffanie A Strathdee; Nicholas Thomson; Stefano Vella; Mauro Schechter; Peter Vickerman; Brian Weir; Chris Beyrer Journal: Lancet Date: 2018-07-20 Impact factor: 79.321
Authors: Larry W Chang; David Serwadda; Thomas C Quinn; Maria J Wawer; Ronald H Gray; Steven J Reynolds Journal: Lancet Infect Dis Date: 2013-01 Impact factor: 25.071
Authors: Elvin H Geng; Mwebesa B Bwana; Winnie Muyindike; David V Glidden; David R Bangsberg; Torsten B Neilands; Ingrid Bernheimer; Nicolas Musinguzi; Constantin T Yiannoutsos; Jeffrey N Martin Journal: J Acquir Immune Defic Syndr Date: 2013-06-01 Impact factor: 3.731
Authors: Shaffiq M Essajee; Stephen M Arpadi; Eric J Dziuban; Raul Gonzalez-Montero; Shirin Heidari; David G Jamieson; Scott E Kellerman; Emilia Koumans; Atieno Ojoo; Emilia Rivadeneira; Stephen A Spector; Helena Walkowiak Journal: AIDS Date: 2013-11 Impact factor: 4.177