Peer support and improved quality of life among persons living with HIV on antiretroviral treatment: A randomised controlled trial from north-eastern Vietnam

Health and Quality of Life Outcomes

Anna Thorson²  Gaetano Marrone²  Phuc Dang Ho⁶  Chuc Thi Kim Nguyen³  Hoa Phuong Nguyen³  Björn Diedrichs⁴  Anastasia Pharris²  Mattias Larsson⁵  Vu Van Tam¹ 

[1] Department of Infectious diseases, Uong Bi general hospital, Uong Bi, Quang Ninh, Vietnam;Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden;Health System Research Project, Ha Noi Medical University, Ha Noi, Vietnam;Sundsvall-Härnösand regional hospital, Sundsvall, Sweden;Oxford University Clinical Research Unit, Ha Noi, Vietnam;Department of Probability and Mathematical Statistics, Institute of Mathematics, Ha Noi, Vietnam

关键词: Randomised controlled trial;    Vietnam;    Quang Ninh;    ART;    HIV;    Peer support;    Quality of life;   

Others  :  825620
DOI  :  10.1186/1477-7525-10-53

 received in 2011-08-30, accepted in 2012-04-26,  发布年份 2012

【 摘 要 】

Background

Among people living with HIV (PLHIV) on antiretroviral therapy (ART), it is important to determine how quality of life (QOL) may be improved and HIV-related stigma can be lessened over time. This study assessed the effect of peer support on QOL and internal stigma during the first year after initiating ART among a cohort of PLHIV in north-eastern Vietnam.

Methods

A sub-sample study of a randomised controlled trial was implemented between October 2008 and November 2010 in Quang Ninh, Vietnam. In the intervention group, participants (n = 119) received adherence support from trained peer supporters who visited participants’ houses biweekly during the first two months, thereafter weekly. In the control group, participants (n = 109) were treated according to standard guidelines, including adherence counselling, monthly health check and drug refills. Basic demographics were measured at baseline. QOL and internal stigma were measured using a Vietnamese version of the WHOQOL-HIVBREF and Internal AIDS-related Stigma Scale instruments at baseline and 12 months. T-tests were used to detect the differences between mean values, multilevel linear regressions to determine factors influencing QOL.

Results

Overall, QOL improved significantly in the intervention group compared to the control group. Among participants initiating ART at clinical stages 3 and 4, education at high school level or above and having experiences of a family member dying from HIV were also associated with higher reported QOL. Among participants at clinical stage 1 and 2, there was no significant effect of peer support, whereas having children was associated with an increased QOL. Viral hepatitis was associated with a decreased QOL in both groups. Lower perceived stigma correlated significantly but weakly with improved QOL, however, there was no significant relation to peer support.

Conclusion

The peer support intervention improved QOL after 12 months among ART patients presenting at clinical stages 3 and 4 at baseline, but it had no impact on QOL among ART patients enrolled at clinical stages 1 and 2. The intervention did not have an effect on Internal AIDS-related stigma. To improve QOL for PLHIV on ART, measures to support adherence should be contextualized in accordance with individual clinical and social needs.

【 授权许可】

   
2012 Van Tam et al.; licensee BioMed Central Ltd.

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