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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

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Abstract

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.

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Acknowledgments

The authors thank Caitlin Kennedy (Johns Hopkins University, USA) for editorial contributions and Megan Hosein (Johns Hopkins University, USA) and Julia Peterson (USA) for data collection contributions. This study was supported by The National Institute of Mental Health, National Institutes of Health (K23MH086338), the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institute of Health, and the Johns Hopkins University Center for AIDS Research (P30AI094189).

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Authors and Affiliations

  1. Division of Infectious Diseases, Johns Hopkins School of Medicine, 725 N. Wolfe Street, Suite 216, Baltimore, MD, 21205, USA

    Larry W. Chang, Thomas C. Quinn, Robert C. Bollinger & Steven J. Reynolds

  2. Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Larry W. Chang

  3. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Larry W. Chang, Veena G. Billioux, Ronald H. Gray & Maria J. Wawer

  4. Rakai Health Sciences Program, Rakai, Uganda

    Gertrude Nakigozi & David Serwadda

  5. Laboratory of Immunoregulation, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

    Thomas C. Quinn & Steven J. Reynolds

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  1. Larry W. Chang
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Chang, L.W., Nakigozi, G., Billioux, V.G. et al. 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. AIDS Behav 19, 1742–1751 (2015). https://doi.org/10.1007/s10461-015-1159-y

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