A Randomized Control Trial of a Peer Adherence and Nutritional Support Program for Public Sector Antiretroviral Patients

Booysen, Frederik ; de Walque, Damien ; Over, Mead ; Hashimoto, Satoko ; de Reuck, Chantell

World Bank, Washington, DC

关键词: HIV;    AIDS;    health;    nutrition;    randomized control trials;   

DOI  :  10.1596/1813-9450-7760
RP-ID  :  WPS7760

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Access to antiretroviral treatment hasexpanded rapidly in South Africa, making it the country inthe world with the largest treatment program. Asantiretroviral treatment coverage continues to rise inresource-constrained settings, effective community-basedadherence support interventions are of central importance inensuring the long-term sustainability of treatment. Thispaper reports the findings from a randomized control trialof a peer adherence and nutritional support programimplemented in a public health care setting in SouthAfrica's antiretroviral treatment program. The analysisassesses the impact of these peer adherence and nutritionalsupport interventions on self-reported adherence, timelinessof clinic and hospital visits, and immunologic response toantiretroviral treatment. Peer adherence and nutritionalsupport improved the timeliness of adults´ clinic andhospital visits for routine follow-up while onantiretroviral treatment. Peer adherence support impactedpositively on immunologic response to antiretroviraltreatment. Scale-up of effective and sustainablecommunity-based, peer-driven adherence and nutritionalsupport interventions should form part of the United NationsAIDS Treatment 2.0 strategy's community mobilizationand health system strengthening pillar.