TY - JOUR
T1 - Impact of patient-selected care buddies on adherence to HIV care, disease progression, and conduct of daily life among pre-antiretroviral HIV-infected patients in Rakai, Uganda
T2 - A randomized controlled trial
AU - Nakigozi, Gertrude
AU - Makumbi, Fredrick E.
AU - Bwanika, John B.
AU - Atuyambe, Lynn
AU - Reynolds, Steven J.
AU - Kigozi, Godfrey
AU - Nalugoda, Fred
AU - Chang, Larry W.
AU - Kiggundu, Valerian
AU - Serwadda, David
AU - Wawer, Maria J.
AU - Gray, Ronald H.
AU - Kamya, Moses R.
N1 - Publisher Copyright:
© 2015 Wolters Kluwer Health, Inc.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Background: Data are limited on effects of household or community support persons ("care buddies") on enrollment into and adherence to pre-antiretroviral HIV care. We assessed the impact of care buddies on adherence to HIV clinic appointments, HIV progression, and conduct of daily life among pre-antiretroviral therapy (pre-ART) HIV-infected individuals in Rakai, Uganda. Methods: A total of 1209 HIV-infected pre-ART patients aged ≥15 years were randomized to standard of care (SOC) (n 604) or patient-selected care buddy (PSCB) (n 605) and followed at 6 and 12 months. Outcomes were adherence to clinic visits, HIV disease progression, and self-reported conduct of daily life. Incidence and prevalence rate ratios and 95% confidence intervals (CIs) were used to assess outcomes in the intent-to-treat and as-treated analyses. Results: Baseline characteristics were comparable. In the intent to treat analysis, both arms were comparable with respect to adherence to CD4 monitoring visits [adjusted prevalence risk ratio (adjPRR), 0.98; 95% CI: 0.93 to 1.04; P 0.529], and ART eligibility (adjPRR, 1.00; 95% CI: 0.77 to 1.31; P 0.946). Good conduct of daily life was significantly higher in the PSCB than the SOC arm (adjPRR, 1.08; 95% CI: 1.03 to 1.13; P 0.001). More men (61%) compared with women (30%) selected spouses/partners as buddies (P < 0.0001). Twenty-two percent of PSCB arm participants discontinued use of buddies. Conclusions: In pre-ART persons, having care buddies improved the conduct of daily life of the HIV-infected patients but had no effect on HIV disease progression and only limited effect on clinic appointment adherence.
AB - Background: Data are limited on effects of household or community support persons ("care buddies") on enrollment into and adherence to pre-antiretroviral HIV care. We assessed the impact of care buddies on adherence to HIV clinic appointments, HIV progression, and conduct of daily life among pre-antiretroviral therapy (pre-ART) HIV-infected individuals in Rakai, Uganda. Methods: A total of 1209 HIV-infected pre-ART patients aged ≥15 years were randomized to standard of care (SOC) (n 604) or patient-selected care buddy (PSCB) (n 605) and followed at 6 and 12 months. Outcomes were adherence to clinic visits, HIV disease progression, and self-reported conduct of daily life. Incidence and prevalence rate ratios and 95% confidence intervals (CIs) were used to assess outcomes in the intent-to-treat and as-treated analyses. Results: Baseline characteristics were comparable. In the intent to treat analysis, both arms were comparable with respect to adherence to CD4 monitoring visits [adjusted prevalence risk ratio (adjPRR), 0.98; 95% CI: 0.93 to 1.04; P 0.529], and ART eligibility (adjPRR, 1.00; 95% CI: 0.77 to 1.31; P 0.946). Good conduct of daily life was significantly higher in the PSCB than the SOC arm (adjPRR, 1.08; 95% CI: 1.03 to 1.13; P 0.001). More men (61%) compared with women (30%) selected spouses/partners as buddies (P < 0.0001). Twenty-two percent of PSCB arm participants discontinued use of buddies. Conclusions: In pre-ART persons, having care buddies improved the conduct of daily life of the HIV-infected patients but had no effect on HIV disease progression and only limited effect on clinic appointment adherence.
KW - HIV
KW - Uganda
KW - patient-selected care buddy
KW - pre-ART
KW - randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=84939789783&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84939789783&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000000710
DO - 10.1097/QAI.0000000000000710
M3 - Article
C2 - 26039929
AN - SCOPUS:84939789783
SN - 1525-4135
VL - 70
SP - 75
EP - 82
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 1
ER -