Original Research
Group counselling for adherence support among young people failing first-line antiretroviral therapy in Zimbabwe
Submitted: 05 August 2021 | Published: 29 October 2021
About the author(s)
Bahati Kasimonje, Newlands Clinic, Harare, ZimbabweTinei Shamu, Newlands Clinic, Harare, Zimbabwe; and, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; and, Graduate School of Health Sciences, University of Bern, Bern, Switzerland
Tinahe Mudzviti, Newlands Clinic, Harare, Zimbabwe; and, Department of Pharmacy and Pharmaceutical Sciences, University of Zimbabwe, Harare, Zimbabwe
Ruedi Luethy, Newlands Clinic, Harare, Zimbabwe
Abstract
Background: Sub-optimal adherence to antiretroviral therapy (ART) is reportedly worse amongst young people living with HIV (YPLHIV). Group adherence counselling can be useful to improve adherence.
Objectives: We evaluated an enhanced adherence counselling group intervention (EACGI) amongst YPLHIV failing a non-nucleoside reverse transcriptase (NNRTI)-based first-line ART regimen.
Method: This was a retrospective cohort study using routinely collected data of YPLHIV failing NNRTI-based first-line ART. Patients with confirmed virological failure were referred for EACGI, a 12-week curriculum of weekly, 1.5-h sessions accommodating 8–15 people per group. It aimed to facilitate readiness to switch to second-line ART and improve adherence through a mental health intervention. Viral loads of HIV were measured pre-EACGI; at baseline; 3, 6 and 12 months post switch.
Results: Fifty-seven patients aged 13–25 years were invited to EACGI and followed for up to 48 weeks. Thirty-three (58%) patients attended at least four sessions, whilst 24 (42%) attended none. Amongst those who attended none, two (8%) were transferred out, three (13%) were lost to follow-up and two (8%) had died by week 48 of follow-up, whilst all who attended were still in care. By week 48, amongst patients still in care, 29%, 44% and 67% of those who attended no sessions, 4–9 and 10–12 sessions, respectively, had viral loads of < 50 copies/mL.
Conclusion: An EACGI is a promising intervention for YPLHIV failing ART prior to treatment switch, leading to improved adherence. This study’s findings support the need for further enquiry into rigorous, evidence-based multilevel adherence interventions that are acceptable and effective for YPLHIV.
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Crossref Citations
1. A Systematic Review of Peer Support Interventions for Adolescents Living with HIV in Sub-Saharan Africa
Charisse V. Ahmed, Rebecca Doyle, Darby Gallagher, Olore Imoohi, Ugochi Ofoegbu, Robyn Wright, Mackensie A. Yore, Merrian J. Brooks, Dalmacio Dennis Flores, Elizabeth D. Lowenthal, Bridgette M. Rice, Alison M. Buttenheim
AIDS Patient Care and STDs vol: 37 issue: 11 first page: 535 year: 2023
doi: 10.1089/apc.2023.0094