AIDS and Behavior

, Volume 17, Issue 9, pp 2927–2934

Using Community Health Workers to Improve Clinical Outcomes Among People Living with HIV: A Randomized Controlled Trial

  • Sonjia Kenya
  • Jamal Jones
  • Kristopher Arheart
  • Erin Kobetz
  • Natasha Chida
  • Shelly Baer
  • Alexis Powell
  • Stephen Symes
  • Tai Hunte
  • Anne Monroe
  • Olveen Carrasquillo
Original Paper

DOI: 10.1007/s10461-013-0440-1

Cite this article as:
Kenya, S., Jones, J., Arheart, K. et al. AIDS Behav (2013) 17: 2927. doi:10.1007/s10461-013-0440-1

Abstract

AIDS-related mortality remains a leading cause of preventable death among African-Americans. We sought to determine if community health workers could improve clinical outcomes among vulnerable African-Americans living with HIV in Miami, Florida. We recruited 91 medically indigent persons with HIV viral loads ≥1,000 and/or a CD4 cell count ≤350. Patients were randomized to a community health worker (CHW) intervention or control group. Viral load and CD4 cell count data were abstracted from electronic medical records. At 12 months, the mean VL in the intervention group was log 0.9 copies/μL lower than the control group. The CD4 counts were not significantly different among the groups. Compared to the control group, patients randomized to CHWs experienced statistically significant improvements in HIV viral load. Larger multi-site studies of longer duration are needed to determine whether CHWs should be incorporated into standard treatment models for vulnerable populations living with HIV.

Keywords

Community health workersHIV viral loadAfrican-AmericansHIV disparities

Resumen

La mortalidad relacionada con el SIDA sigue siendo la principal causa de muerte evitable entre los afro-americanos. Nuestro objetivo era determinar si los promotores de salud podrían mejorar los resultados clínicos entre africano-americanos que viven con el VIH en Miami, Florida. Reclutamos a noventa y un personas médicamente indigentes con cargas virales de VIH >1,000 y/o un recuento de células CD4 <350. Los pacientes fueron asignados al azar a un grupo de intervención con un trabajador de salud comunitaria (TSC)/promotor o al grupo control. Los datos de carga viral y recuento de células CD4 fueron extraídos de registros médicos electrónicos. En doce meses, el promedio del VL en el grupo de intervención fué de 0,9 log copias/μL más bajos que los del grupo control. Los recuentos de células CD4 no fueron significativamente diferentes entre los grupos. En comparación con el grupo control, los pacientes asignados al azar a los promotores/TSC experimentaron mejoras estadísticamente significativas en la carga viral de VIH. Estudios de mayor duración y de sitios múltiples son necesarios para determinar si los promotores/TSC deben ser incorporados en los modelos estándar de tratamiento para las poblaciones vulnerables que viven con el VIH.

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Sonjia Kenya
    • 1
  • Jamal Jones
    • 2
  • Kristopher Arheart
    • 3
  • Erin Kobetz
    • 7
  • Natasha Chida
    • 2
  • Shelly Baer
    • 4
  • Alexis Powell
    • 5
  • Stephen Symes
    • 6
  • Tai Hunte
    • 2
  • Anne Monroe
    • 2
  • Olveen Carrasquillo
    • 1
  1. 1.Division of General MedicineJay Weiss Center Social Medicine and Health Equity, University of Miami Miller School of MedicineMiamiUSA
  2. 2.Jay Weiss Center for Social Medicine and Health Equity, University of Miami Miller School of MedicineMiamiUSA
  3. 3.Department of Epidemiology and Public HealthUniversity of Miami Miller School of MedicineMiamiUSA
  4. 4.Department of PediatricsMailman Center for Child Development, University of Miami Miller School of MedicineMiamiUSA
  5. 5.Division of Infectious DiseasesUniversity of Miami Miller School of MedicineMiamiUSA
  6. 6.Division of Infectious DiseasesJay Weiss Center Social Medicine and Health Equity, University of Miami Miller School of MedicineMiamiUSA
  7. 7.Department of Epidemiology and Public HealthJay Weiss Center for Social Medicine and Health Equity, University of Miami Miller School of MedicineMiamiUSA