Effect of Peer Health Workers on AIDS Care in Rakai, Uganda: A Cluster-Randomized Trial

Simple item page
dc.contributor.authorChang, Larry W.
dc.contributor.authorKagaayi, Joseph
dc.contributor.authorNakigozi, Gertrude
dc.contributor.authorSsempijja, Victor
dc.contributor.authorPacker, Arnold H.
dc.contributor.authorSerwadda, David
dc.contributor.authorQuinn, Thomas C.
dc.contributor.authorGray, Ronald H.
dc.contributor.authorBollinger, Robert C.
dc.contributor.authorReynolds, Steven J.
dc.date.accessioned2021-12-15T11:39:19Z
dc.date.available2021-12-15T11:39:19Z
dc.date.issued2010
dc.description.abstractHuman resource limitations are a challenge to the delivery of antiretroviral therapy (ART) in low-resource settings. We conducted a cluster randomized trial to assess the effect of community-based peer health workers (PHW) on AIDS care of adults in Rakai, Uganda. Methodology/Principal Findings: 15 AIDS clinics were randomized 2:1 to receive the PHW intervention (n = 10) or control (n = 5). PHWtasks included clinic and home-based provision of counseling, clinical, adherence to ART, and social support. Primary outcomes were adherence and cumulative risk of virologic failure (.400 copies/mL). Secondary outcomes were virologic failure at each 24 week time point up to 192 weeks of ART. Analysis was by intention to treat. FromMay 2006 to July 2008, 1336 patients were followed. 444 (33%) of these patients were already on ART at the start of the study. No significant differences were found in lack of adherence (,95% pill count adherence risk ratio [RR] 0.55, 95% confidence interval [CI] 0.23–1.35; ,100% adherence RR 1.10, 95% CI 0.94–1.30), cumulative risk of virologic failure (RR 0.81, 95% CI 0.61–1.08) or in shorter-term virologic outcomes (24 week virologic failure RR 0.93, 95% CI 0.65–1.32; 48 week, RR 0.83, 95% CI 0.47–1.48; 72 week, RR 0.81, 95% CI 0.44–1.49). However, virologic failure rates$96 weeks into ART were significantly decreased in the intervention armcompared to the control arm (96 week failure RR 0.50, 95% CI 0.31–0.81; 120 week, RR 0.59, 95% CI 0.22–1.60; 144 week, RR 0.39, 95% CI 0.16–0.95; 168 week, RR 0.30, 95% CI 0.097–0.92; 192 week, RR 0.067, 95% CI 0.0065–0.71). Conclusions/Significance: A PHW intervention was associated with decreased virologic failure rates occurring 96 weeks and longer into ART, but did not affect cumulative risk of virologic failure, adherence measures, or shorter-term virologic outcomes. PHWs may be an effective intervention to sustain long-term ART in low-resource settingsen_US
dc.identifier.citationChang, L. W., Kagaayi, J., Nakigozi, G., Ssempijja, V., Packer, A. H., Serwadda, D., ... & Reynolds, S. J. (2010). Effect of peer health workers on AIDS care in Rakai, Uganda: a cluster-randomized trial. PloS one, 5(6), e10923.en_US
dc.identifier.urihttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0010923
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/590
dc.language.isoenen_US
dc.publisherPloS oneen_US
dc.subjectPeer Health Workersen_US
dc.subjectAIDS Careen_US
dc.subjectRakaien_US
dc.titleEffect of Peer Health Workers on AIDS Care in Rakai, Uganda: A Cluster-Randomized Trialen_US
dc.typeArticleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Effect of Peer Health Workers on AIDS Care in Rakai,.pdf
Size:
254.53 KB
Format:
Adobe Portable Document Format
Description:
Article
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Medical and Health Sciences