Effect and implementation experience of intensive adherence counseling in a public HIV care center in Uganda: a mixed‑methods study

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dc.contributor.authorLukyamuzi, Zubair
dc.contributor.authorEtajak, Samuel
dc.contributor.authorKatairo, Thomas
dc.contributor.authorMukunya, David
dc.contributor.authorTetui, Moses
dc.contributor.authorSsenyonjo, Aloysius
dc.contributor.authorWanyenze, Rhoda K.
dc.date.accessioned2022-02-15T11:35:44Z
dc.date.available2022-02-15T11:35:44Z
dc.date.issued2021
dc.description.abstractIntensive adherence counseling (IAC) is an intervention recommended by the World Health Organization to improve anti-retroviral therapy (ART) adherence among people living with HIV on ART with unsuppressed viral load; and in 2016, the intervention was implemented in Uganda. This study evaluated the effect and experiences of providing IAC in an urban HIV care center in Kampala, Uganda. Methods: This was a sequential explanatory mixed-method study that compared viral load suppression during IAC implementation (intervention) to the period before IAC at Kisenyi Health centre IV. Data were abstracted from patient files and viral load register. The effect of IAC on viral load suppression and associated factors were analyzed using modified Poisson regression with robust standard errors. Using in-depth interviews and an inductive analysis approach in Atlas-ti 8. We also explored experiences of providing IAC among healthcare workers. Results: A total of 500 records were sampled: 249 (49.8%) in the intervention period and 251 (51.2%) in the preintervention period. The mean age was lower during the intervention period 33.1 (± 12.0) than 36.5 (± 13.4) in the pre- intervention period, p = 0.002. More clients were currently on Protease-based regimen in the pre-intervention period 179 (71.3%) than 135 (54.2%) in the intervention period, p ≤ 0.001. In the intervention period, all eligible clients received IAC [249/249 (100.0%)]. Overall, 325 (65.0%) received IAC and of these, 143 (44.1%) achieved viral load suppression compared to 46 (26.3%) who received regular counseling. Receiving IAC significantly increased viral load suppression by 22% (aPR 1.22, 95% CI 1.01–1.47). Clients on Protease-based regimen were less likely to suppress than those on Efavirenz or Nevirapine-based regimens (aPR 0.11, 95% CI 0.08–0.15). All the interviewed healthcare workers lauded IAC for improving ART adherence. However, patient and health care system related factors hindered adherence during IAC.en_US
dc.identifier.citationLukyamuzi, Z., Etajak, S., Katairo, T., Mukunya, D., Tetui, M., Ssenyonjo, A., & Wanyenze, R. K. (2021). Effect and implementation experience of intensive adherence counseling in a public HIV care center in Uganda: a mixed-methods study. BMC infectious diseases, 21(1), 1-15.https://doi.org/10.1186/s12879-021-06862-6en_US
dc.identifier.urihttps://doi.org/10.1186/s12879-021-06862-6
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/2132
dc.language.isoenen_US
dc.publisherBMC infectious diseasesen_US
dc.subjectIntensive adherence counselingen_US
dc.subjectPeople living with HIVen_US
dc.subjectUnsuppressed viral loaden_US
dc.subjectPublic HIV care centeren_US
dc.subjectUgandaen_US
dc.titleEffect and implementation experience of intensive adherence counseling in a public HIV care center in Uganda: a mixed‑methods studyen_US
dc.typeArticleen_US
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