Prudence Mbah1,2, Michael Iroezindu3,4, Allahna L Esber1,5, Nicole Dear1,5, Domonique Reed1,5, Yakubu Adamu6, Abdulwasiu Bolaji Tiamiyu1,2, Samirah Sani Mohammed1,2, Hannah Kibuuka7, Jonah Maswai1,8, John Owuoth9,10, Emmanuel Bahemana1,11, Julie A Ake1, Christina S Polyak1,5, Trevor A Crowell1,5. 1. U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA. 2. HJF Medical Research International, Abuja, Nigeria. 3. U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA. miroezindu@wrp-n.org. 4. HJF Medical Research International, Abuja, Nigeria. miroezindu@wrp-n.org. 5. Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, USA. 6. U.S. Army Medical Research Directorate - Africa, Abuja, Nigeria. 7. Makerere University Walter Reed Project, Kampala, Uganda. 8. HJF Medical Research International, Kericho, Kenya. 9. U.S. Army Medical Research Directorate - Africa, Kisumu, Kenya. 10. HJF Medical Research International, Kisumu, Kenya. 11. HJF Medical Research International, Mbeya, Tanzania.
Abstract
BACKGROUND: Support groups for people living with HIV (PLWH) may improve HIV care adherence and outcomes. We assessed the impact of support group attendance on antiretroviral therapy (ART) adherence and viral suppression in four African countries. METHODS: The ongoing African Cohort Study (AFRICOS) enrolls participants at 12 clinics in Kenya, Uganda, Tanzania, and Nigeria. Self-reported attendance of any support group meetings, self-reported ART adherence, and HIV RNA are assessed every 6 months. Logistic regression models with generalized estimating equations were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for support group attendance and other factors potentially associated with ART adherence and viral suppression. RESULTS: From January 2013 to December 1, 2019, 1959 ART-experienced PLWH were enrolled and 320 (16.3%) reported any support group attendance prior to enrollment. Complete ART adherence, with no missed doses in the last 30 days, was reported by 87.8% while 92.4% had viral suppression <1000copies/mL across all available visits. There was no association between support group attendance and ART adherence in unadjusted (OR 1.01, 95% CI 0.99-1.03) or adjusted analyses (aOR 1.00, 95% CI 0.98-1.02). Compared to PLWH who did not report support group attendance, those who did had similar odds of viral suppression in unadjusted (OR 0.99, 95% CI 0.978-1.01) and adjusted analyses (aOR 0.99, 95% CI 0.97-1.01). CONCLUSION: Support group attendance was not associated with significantly improved ART adherence or viral suppression, although low support group uptake may have limited our ability to detect a statistically significant impact.
BACKGROUND: Support groups for people living with HIV (PLWH) may improve HIV care adherence and outcomes. We assessed the impact of support group attendance on antiretroviral therapy (ART) adherence and viral suppression in four African countries. METHODS: The ongoing African Cohort Study (AFRICOS) enrolls participants at 12 clinics in Kenya, Uganda, Tanzania, and Nigeria. Self-reported attendance of any support group meetings, self-reported ART adherence, and HIV RNA are assessed every 6 months. Logistic regression models with generalized estimating equations were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for support group attendance and other factors potentially associated with ART adherence and viral suppression. RESULTS: From January 2013 to December 1, 2019, 1959 ART-experienced PLWH were enrolled and 320 (16.3%) reported any support group attendance prior to enrollment. Complete ART adherence, with no missed doses in the last 30 days, was reported by 87.8% while 92.4% had viral suppression <1000copies/mL across all available visits. There was no association between support group attendance and ART adherence in unadjusted (OR 1.01, 95% CI 0.99-1.03) or adjusted analyses (aOR 1.00, 95% CI 0.98-1.02). Compared to PLWH who did not report support group attendance, those who did had similar odds of viral suppression in unadjusted (OR 0.99, 95% CI 0.978-1.01) and adjusted analyses (aOR 0.99, 95% CI 0.97-1.01). CONCLUSION: Support group attendance was not associated with significantly improved ART adherence or viral suppression, although low support group uptake may have limited our ability to detect a statistically significant impact.
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