Process evaluation of an intervention to improve HIV treatment outcomes among children and adolescents-Reference-Cited by-同舟云学术

Process evaluation of an intervention to improve HIV treatment outcomes among children and adolescents

Published:2022-09-21 Issue:3 Volume:12 Page:108-114
ISSN:2220-8372
Container-title:Public Health Action
language:en
Short-container-title:public health action

Author:

Seguin M.¹,Dringus S.²,Chiomvu S.³,Apollo T.⁴,Sibanda E.⁵,Simms V.⁶,Bernays S.⁷,Chikodzore R.⁸,Redzo N.⁹,Mlilo P.⁹,Ndlovu L.⁹,Nzombe P.⁹,Ncube B.⁹,Kranzer K.¹⁰,Abbas Ferrand R.¹¹,Chikwari C. D.¹¹

Affiliation:

1. Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK

2. Global Health Department, London School of Hygiene and Tropical Medicine, London, UK

3. Million Memory Project Zimbabwe, Bulawayo, Zimbabwe

4. AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe

5. Health Services Department, Bulawayo City Health, Bulawayo, Zimbabwe

6. Biomedical Research and Training Institute, Harare, Zimbabwe, International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK

7. Global Health Department, London School of Hygiene and Tropical Medicine, London, UK, School of Public Health, University of Sydney, Sydney, NSW, Australia

8. Ministry of Health and Child Care, Gwanda, Zimbabwe

9. Biomedical Research and Training Institute, Harare, Zimbabwe

10. Biomedical Research and Training Institute, Harare, Zimbabwe, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK, Division of Infectious and Tropical Medicine, Medical Centre of the University of Munich, Munich, Germany

11. Biomedical Research and Training Institute, Harare, Zimbabwe, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK

Abstract

SETTING: Children and adolescents with HIV encounter challenges in initiation and adherence to antiretroviral therapy (ART). A community-based support intervention of structured home visits, aimed at improving initiation, adherence and treatment, was delivered by community health workers (CHWs) to children and adolescents newly diagnosed with HIV.OBJECTIVES: To 1) describe intervention delivery, 2) explore CHW, caregiver and adolescents’ perceptions of the intervention, 3) identify barriers and facilitators to implementation, and 4) ascertain treatment outcomes at 12 months’ post-HIV diagnosis.DESIGN: We drew upon: 1) semi-structured interviews (n = 22) with 5 adolescents, 11 caregivers and 6 CHWs, 2) 28 CHW field manuals, and 3) quantitative data for study participants (demographic information and HIV clinical outcomes).RESULTS: Forty-one children received at least a part of the intervention. Of those whose viral load was tested, 26 (n = 32, 81.3%) were virally suppressed. Interviewees felt that the intervention supported ART adherence and strengthened mental health. Facilitators to intervention delivery were convenience and rapport between CHWs and families. Stigma, challenges in locating participants and inadequate resources for CHWs were barriers.CONCLUSION: This intervention was helpful in supporting HIV treatment adherence among adolescents and children. Facilitators and barriers may be useful in developing future interventions.

Publisher

International Union Against Tuberculosis and Lung Disease

Subject

Public Health, Environmental and Occupational Health,Health Policy

Reference3 articles.

1. Implementation of a comprehensive program including psycho-social and treatment literacy activities to improve adherence to HIV care and treatment for a pediatric population in Kenya

2. Loss to follow-up among children and adolescents growing up with HIV infection: age really matters