Lung Vu1, Brady Burnett-Zieman2, Cecily Banura3, Jerry Okal4, Margret Elang5, Rodgers Ampwera5, Georgina Caswell6, Diana Amanyire7, Jacquelyne Alesi8, Eileen Yam2. 1. Population Council, Washington, DC. Electronic address: lvu@popcouncil.org. 2. Population Council, Washington, DC. 3. Child Health and Development Center, Makerere University College of Health Sciences, Kampala, Uganda. 4. Population Council, Nairobi, Kenya. 5. Community Health Alliance Uganda (CHAU), Kampala, Uganda. 6. International HIV/AIDS Alliance, Cape Town, South Africa. 7. Marie Stopes International, Uganda (MSIU), Kampala, Uganda. 8. Uganda Network of Young People Living with HIV and AIDS, Kampala, Uganda.
Abstract
PURPOSE: To address barriers to care for youth living with HIV (YLHIV), the Link Up project implemented a peer-led intervention model that provided a comprehensive package of HIV and sexual and reproductive health and rights services through community-based peer support groups for YLHIV. Peer educators delivered targeted counseling and health education, and referred YLHIV to antiretroviral therapy (ART), and reproductive health services that were available at youth-oriented sexual and reproductive health and rights facilities. METHODS: At baseline (October to November 2014), 37 peer support groups for YLHIV were established in Luwero and Nakasongola districts. During this same time period, we recruited a cohort of 473 support group members, aged 15-24 years. After a 9-month intervention period (January to September 2015), we completed the end-line survey with 350 members of the original cohort. Multivariate logistic regression analysis applied to longitudinal data was used to assess changes in key outcomes from baseline to end line. RESULTS: Multivariate analyses showed significant increases at end line, compared with baseline, in self-efficacy (adjusted odds ratio [AOR]: 1.8 [1.3-2.6]), comprehensive HIV knowledge [AOR: 1.8 [1.3-2.6]), HIV disclosure (AOR: 1.6 [1.01-2.6]), condom use at last sex (AOR: 1.7 [1.2-2.5]), sexually transmitted infection uptake (AOR: 2.1 [1.5-2.9]), ART uptake (AOR: 2.5 [1.6-4.0]), ART adherence (AOR: 2.5 [1.3-4.9]), CD4 testing (AOR: 2.4 [1.5-3.6]), and current use of a modern contraceptive method (AOR: 1.7 [1.1-2.7]). CONCLUSIONS: Link Up's intervention strategy likely contributed to observed increases in self-efficacy, knowledge of HIV, condom use, HIV disclosure ART utilization and adherence, CD4 testing, STI testing uptake, and use of modern family planning methods. This model shows promise and should be adapted for use among YLHIV in similar settings and evaluated further.
PURPOSE: To address barriers to care for youth living with HIV (YLHIV), the Link Up project implemented a peer-led intervention model that provided a comprehensive package of HIV and sexual and reproductive health and rights services through community-based peer support groups for YLHIV. Peer educators delivered targeted counseling and health education, and referred YLHIV to antiretroviral therapy (ART), and reproductive health services that were available at youth-oriented sexual and reproductive health and rights facilities. METHODS: At baseline (October to November 2014), 37 peer support groups for YLHIV were established in Luwero and Nakasongola districts. During this same time period, we recruited a cohort of 473 support group members, aged 15-24 years. After a 9-month intervention period (January to September 2015), we completed the end-line survey with 350 members of the original cohort. Multivariate logistic regression analysis applied to longitudinal data was used to assess changes in key outcomes from baseline to end line. RESULTS: Multivariate analyses showed significant increases at end line, compared with baseline, in self-efficacy (adjusted odds ratio [AOR]: 1.8 [1.3-2.6]), comprehensive HIV knowledge [AOR: 1.8 [1.3-2.6]), HIV disclosure (AOR: 1.6 [1.01-2.6]), condom use at last sex (AOR: 1.7 [1.2-2.5]), sexually transmitted infection uptake (AOR: 2.1 [1.5-2.9]), ART uptake (AOR: 2.5 [1.6-4.0]), ART adherence (AOR: 2.5 [1.3-4.9]), CD4 testing (AOR: 2.4 [1.5-3.6]), and current use of a modern contraceptive method (AOR: 1.7 [1.1-2.7]). CONCLUSIONS: Link Up's intervention strategy likely contributed to observed increases in self-efficacy, knowledge of HIV, condom use, HIV disclosure ART utilization and adherence, CD4 testing, STI testing uptake, and use of modern family planning methods. This model shows promise and should be adapted for use among YLHIV in similar settings and evaluated further.
Authors: Christina A Laurenzi; Sarah Skeen; Sarah Gordon; Olamide Akin-Olugbade; Nina Abrahams; Melissa Bradshaw; Amanda Brand; Stefani du Toit; G J Melendez-Torres; Mark Tomlinson; Chiara Servili; Tarun Dua; David A Ross Journal: J Int AIDS Soc Date: 2020-09 Impact factor: 5.396