title: Adapting and Implementing a Community Program to Improve Retention in Care among Patients with HIV in Southern Haiti: "Group of 6".
abstract: Objective. In Mozambique, a patient-led Community ART Group model developed by Médecins Sans Frontières improved retention in care and adherence to antiretroviral therapy (ART) among persons with HIV. We describe the adaptation and implementation of this model within the HIV clinic located in the largest public hospital in Haiti's Southern Department. Methods. Our adapted model was named Group of 6. Hospital staff enabled stable patients with HIV receiving ART to form community groups with 4-6 members to facilitate monthly ART distribution, track progress and adherence, and provide support. Implementation outcomes included recruitment success, participant retention, group completion of monthly monitoring forms, and satisfaction surveys. Results. Over one year, 80 patients from nine communities enrolled into 15 groups. Six participants left to receive HIV care elsewhere, two moved away, and one died of a non-HIV condition. Group members successfully completed monthly ART distribution and returned 85.6% of the monthly monitoring forms. Members reported that Group of 6 made their HIV management easier and hospital staff reported that it reduced their workload. Conclusions. We report successful adaptation and implementation of a validated community HIV-care model in Southern Haiti. Group of 6 can reduce barriers to ART adherence, and will be integrated as a routine care option.
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, USA.
authors.forename: John A
authors.identifier: 0000-0001-6777-0104
authors.initials: JA
authors.lastname: Naslund
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Jodie
authors.identifier: 0000-0002-3625-5174
authors.initials: J
authors.lastname: Dionne-Odom
authors.affiliation: Centres GHESKIO, Port-au-Prince, Haiti ; Hôpital Immaculée Conception, Les Cayes, Southern Department, Haiti.
authors.forename: Cléonas
authors.initials: C
authors.lastname: Junior Destiné
authors.affiliation: Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Jogerst
authors.affiliation: Hôpital Immaculée Conception, Les Cayes, Southern Department, Haiti.
authors.forename: Redouin
authors.initials: R
authors.lastname: Renold Sénécharles
authors.affiliation: Hôpital Immaculée Conception, Les Cayes, Southern Department, Haiti.
authors.forename: Michelande
authors.initials: M
authors.lastname: Jean Louis
authors.affiliation: Hôpital Immaculée Conception, Les Cayes, Southern Department, Haiti.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Desir
authors.affiliation: Hôpital Immaculée Conception, Les Cayes, Southern Department, Haiti.
authors.forename: Yvette
authors.initials: Y
authors.lastname: Néptune Ledan
authors.affiliation: Centres GHESKIO, Port-au-Prince, Haiti ; Hôpital Immaculée Conception, Les Cayes, Southern Department, Haiti.
authors.forename: Jude Ronald
authors.initials: JR
authors.lastname: Beauséjour
authors.affiliation: United States Centers for Disease Control and Prevention, Les Cayes, Southern Department, Haiti.
authors.forename: Roland
authors.initials: R
authors.lastname: Charles
authors.affiliation: Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Werbel
authors.affiliation: Division of Infectious Disease and International Health, Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Talbot
authors.affiliation: Centres GHESKIO, Port-au-Prince, Haiti.
authors.forename: Patrice
authors.initials: P
authors.lastname: Joseph
authors.affiliation: Centres GHESKIO, Port-au-Prince, Haiti ; Center for Global Health, Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Jean William
authors.initials: JW
authors.lastname: Pape
authors.affiliation: Division of Infectious Disease and International Health, Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Wright