Sanele Ngcobo, Steve Olorunju, Tshifhiwa Nkwenika, Theresa Rossouw
{"title":"基于病房的外展团队和依从性游戏对保留率和病毒载量抑制的影响。","authors":"Sanele Ngcobo, Steve Olorunju, Tshifhiwa Nkwenika, Theresa Rossouw","doi":"10.4102/sajhivmed.v23i1.1446","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Only 66% of South African people living with HIV (PLWH) are virologically suppressed. Therefore, it is important to develop strategies to improve outcomes.</p><p><strong>Objectives: </strong>Assess the effect of interventions on 12-month retention in care and virological suppression in participants newly initiated on antiretroviral therapy.</p><p><strong>Method: </strong>Fifty-seven clinics were randomised into four arms: Ward-based primary health care outreach teams (WBPHCOTs); Game; WBPHCOT-Game in combination; and Control (standard of care). Sixteen clinics were excluded and four re-allocated because lay counsellors and operational team leaders failed to attend the required training. Seventeen clinics were excluded due to non-enrolment.</p><p><strong>Results: </strong>A total of 558 participants from Tshwane district were enrolled. After excluding ineligible participants, 467 participants were included in the analysis: WBPHCOTs (<i>n</i> = 72); Games (<i>n</i> = 126); WBPHCOT-Games (<i>n</i> = 85); and Control (<i>n</i> = 184). Retention in care at 12 months was evaluable in 340 participants (86.2%) were retained in care and 13.8% were lost to follow-up. The intervention groups had higher retention in care than the Control group, but this only reached statistical significance in the Games group (96.8% vs 77.8%; relative risk [RR] 1.25; 95% confidence interval [CI]: 1.13-1.38; <i>P</i> = 0.01). The 12 month virologic suppression rate was 75.3% and was similar across the four arms.</p><p><strong>Conclusion: </strong>This study demonstrated that an adherence game intervention could help keep PLWH in care.</p><p><strong>What this study adds: </strong>Evidence that interventions, especially Games, could improve retention in care.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"23 1","pages":"1446"},"PeriodicalIF":1.6000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772703/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of a ward-based outreach team and adherence game on retention and viral load suppression.\",\"authors\":\"Sanele Ngcobo, Steve Olorunju, Tshifhiwa Nkwenika, Theresa Rossouw\",\"doi\":\"10.4102/sajhivmed.v23i1.1446\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Only 66% of South African people living with HIV (PLWH) are virologically suppressed. Therefore, it is important to develop strategies to improve outcomes.</p><p><strong>Objectives: </strong>Assess the effect of interventions on 12-month retention in care and virological suppression in participants newly initiated on antiretroviral therapy.</p><p><strong>Method: </strong>Fifty-seven clinics were randomised into four arms: Ward-based primary health care outreach teams (WBPHCOTs); Game; WBPHCOT-Game in combination; and Control (standard of care). Sixteen clinics were excluded and four re-allocated because lay counsellors and operational team leaders failed to attend the required training. Seventeen clinics were excluded due to non-enrolment.</p><p><strong>Results: </strong>A total of 558 participants from Tshwane district were enrolled. After excluding ineligible participants, 467 participants were included in the analysis: WBPHCOTs (<i>n</i> = 72); Games (<i>n</i> = 126); WBPHCOT-Games (<i>n</i> = 85); and Control (<i>n</i> = 184). Retention in care at 12 months was evaluable in 340 participants (86.2%) were retained in care and 13.8% were lost to follow-up. The intervention groups had higher retention in care than the Control group, but this only reached statistical significance in the Games group (96.8% vs 77.8%; relative risk [RR] 1.25; 95% confidence interval [CI]: 1.13-1.38; <i>P</i> = 0.01). 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Effect of a ward-based outreach team and adherence game on retention and viral load suppression.
Background: Only 66% of South African people living with HIV (PLWH) are virologically suppressed. Therefore, it is important to develop strategies to improve outcomes.
Objectives: Assess the effect of interventions on 12-month retention in care and virological suppression in participants newly initiated on antiretroviral therapy.
Method: Fifty-seven clinics were randomised into four arms: Ward-based primary health care outreach teams (WBPHCOTs); Game; WBPHCOT-Game in combination; and Control (standard of care). Sixteen clinics were excluded and four re-allocated because lay counsellors and operational team leaders failed to attend the required training. Seventeen clinics were excluded due to non-enrolment.
Results: A total of 558 participants from Tshwane district were enrolled. After excluding ineligible participants, 467 participants were included in the analysis: WBPHCOTs (n = 72); Games (n = 126); WBPHCOT-Games (n = 85); and Control (n = 184). Retention in care at 12 months was evaluable in 340 participants (86.2%) were retained in care and 13.8% were lost to follow-up. The intervention groups had higher retention in care than the Control group, but this only reached statistical significance in the Games group (96.8% vs 77.8%; relative risk [RR] 1.25; 95% confidence interval [CI]: 1.13-1.38; P = 0.01). The 12 month virologic suppression rate was 75.3% and was similar across the four arms.
Conclusion: This study demonstrated that an adherence game intervention could help keep PLWH in care.
What this study adds: Evidence that interventions, especially Games, could improve retention in care.
期刊介绍：
The Southern African Journal of HIV Medicine is focused on HIV/AIDS treatment, prevention and related topics relevant to clinical and public health practice. The purpose of the journal is to disseminate original research results and to support high-level learning related to HIV Medicine. It publishes original research articles, editorials, case reports/case series, reviews of state-of-the-art clinical practice, and correspondence.
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