Effectiveness of peer support on care engagement and preventive care intervention utilization among pre-antiretroviral therapy, HIV-infected adults in Rakai, Uganda: a randomized trial.
442 pre-ART, HIV-infected adults were randomized to peer support consisting of structured home visits to promote clinic attendance and preventive care intervention use or standard of care. At baseline, 62 % reported previously visiting an HIV clinic, 45 % reported taking cotrimoxazole prophylaxis, and 31 % were "care-naïve" (no previous clinic visit and not on cotrimoxazole). After 1 year, intervention participants were more likely to report being in care (92 vs 84 %; PRR 1.09, p = 0.039), on cotrimoxazole (89 vs 81 %; PRR 1.10, p = 0.047), and safe water vessel adherence (23 vs 14 %; PRR 1.64, p = 0.024). The effect was observed only among care-naïve participants (n = 139) with 83 % intervention versus 56 % controls reporting being in HIV care (PRR 1.47, p = 0.006), 78 versus 58 % on cotrimoxazole (PRR 1.35, p = 0.04), and 20 versus 4 % safe water vessel adherence (PRR 5.78, p = 0.017). Peer support may be an effective intervention to facilitate pre-ART care compliance in this important population.
Division of Infectious Diseases, Johns Hopkins School of Medicine, 725 N. Wolfe Street, Suite 216, Baltimore, MD, 21205, USA. larrywillchang@gmail.com.|Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. larrywillchang@gmail.com.|Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. larrywillchang@gmail.com.
Larry W
LW
Chang
Rakai Health Sciences Program, Rakai, Uganda.
Gertrude
G
Nakigozi
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Veena G
VG
Billioux
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Ronald H
RH
Gray
Rakai Health Sciences Program, Rakai, Uganda.
David
D
Serwadda
Division of Infectious Diseases, Johns Hopkins School of Medicine, 725 N. Wolfe Street, Suite 216, Baltimore, MD, 21205, USA.|Laboratory of Immunoregulation, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
Thomas C
TC
Quinn
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Maria J
MJ
Wawer
Division of Infectious Diseases, Johns Hopkins School of Medicine, 725 N. Wolfe Street, Suite 216, Baltimore, MD, 21205, USA.
Robert C
RC
Bollinger
Division of Infectious Diseases, Johns Hopkins School of Medicine, 725 N. Wolfe Street, Suite 216, Baltimore, MD, 21205, USA.|Laboratory of Immunoregulation, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
Steven J
SJ
Reynolds
D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy*; D006792:House Calls / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data*; D010379:Peer Group; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014454:Uganda
D019380:Anti-HIV Agents
Implementation science; Linkage; Peer support; Randomized controlled trial; Uganda