AIDS and Behavior

, Volume 15, Issue 8, pp 1795–1802

Improving Clinic Attendance and Adherence to Antiretroviral Therapy Through a Treatment Supporter Intervention in Uganda: A Randomized Controlled Trial

  • Setor Kunutsor
  • John Walley
  • Elly Katabira
  • Simon Muchuro
  • Hudson Balidawa
  • Elizabeth Namagala
  • Eric Ikoona
Original Paper

DOI: 10.1007/s10461-011-9927-9

Cite this article as:
Kunutsor, S., Walley, J., Katabira, E. et al. AIDS Behav (2011) 15: 1795. doi:10.1007/s10461-011-9927-9

Abstract

We assessed the effectiveness of the treatment supporter initiative as an intervention in improving clinic attendance for antiretroviral (ARV) drug refills and adherence to antiretroviral therapy (ART) in a cohort of HIV-infected adults. This two-arm randomized controlled trial was undertaken at an HIV clinic in a district hospital in Uganda. A total of 174 adult patients on ART were randomized 1:1 to a standard adherence intervention package plus a treatment supporter intervention (TS arm) or to a standard adherence intervention package (non-TS arm) alone. Clinic attendance for refills and adherence measurements using monthly clinic-based pill counts were monitored for both arms for 28 weeks. Baseline characteristics were similar for both arms. There was a non-significant difference in mean adherence between the TS and non-TS groups at end of follow-up [99.1% (95% CI: 98.3–99.9% vs. 96.3% (95% CI: 94.2–98.3%), P > 0.05]. TS participants had more than four times the odds of achieving optimal adherence (≥95%) [Odds ratio (OR) = 4.51, 95% CI: 1.22–16.62, exact P = 0.027]. TS participants were also more likely to be on time for their clinic appointments: 91.6 vs. 90.1% for TS and non-TS, respectively (OR = 1.19, 95% CI: 0.74–1.91, P > 0.05). Use of patient-selected treatment supporters may be an effective intervention to improve ARV treatment outcomes in resource-constrained settings.

Keywords

Treatment supporterClinic attendanceAdherenceAnti-retroviral therapyHIV/AIDS

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Setor Kunutsor
    • 1
    • 4
  • John Walley
    • 1
  • Elly Katabira
    • 2
  • Simon Muchuro
    • 2
  • Hudson Balidawa
    • 3
  • Elizabeth Namagala
    • 3
  • Eric Ikoona
    • 3
  1. 1.Nuffield Centre for International Health and Development, Institute of Health SciencesLeeds UniversityLeedsUK
  2. 2.Communicable Disease Research Programme Consortium, Department of MedicineMakerere University College of Health SciencesKampalaUganda
  3. 3.Uganda National AIDS Control ProgrammeKampalaUganda
  4. 4.Malaria Consortium, COMDIS MUKKampalaUganda