Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr 26;16(4):e0250345.
doi: 10.1371/journal.pone.0250345. eCollection 2021.

Effect of community antiretroviral therapy on treatment outcomes among stable antiretroviral therapy patients in Nigeria: A quasi experimental study

Patrick Dakum  1   2 , Juliet Ajav-Nyior  1 , Timothy A Attah  1 , Gbenga A Kayode  1   3 , Asabe Gomwalk  1 , Helen Omuh  1 , Halima Ibrahim  1 , Mercy Omozuafoh  1 , Abimiku Alash'le  2   3 , Charles Mensah  1 , Young Oluokun  1 , Franca Akolawole  1
Affiliations

Effect of community antiretroviral therapy on treatment outcomes among stable antiretroviral therapy patients in Nigeria: A quasi experimental study

Patrick Dakum et al. PLoS One. .

Abstract

Objectives: This study evaluates the effect of Community Anti-retroviral Groups on Immunologic, Virologic and clinical outcomes of stable Antiretroviral Therapy patients in Nigeria.

Method: A cohort of 251 eligible adults (≥18 years) on first-line ART for at least 6 months with CD4 counts >200 cells/mm3 and viral load <1000 c/ml were devolved from 10 healthcare facilities to 51 community antiretroviral therapy groups. Baseline immunologic, virologic and clinical parameters were collected and community antiretroviral therapy group patients were followed up for a year after which Human Immunodeficiency Virus treatment outcomes at the baseline and a year after follow-up were compared using paired sample t-test. All the analyses were performed in STATA version 14.

Result: Out of the 251 stable antiretroviral therapy adults enrolled, 186 (75.3%) were female, 52 (22.7%) had attained post-secondary education and the mean age of participants was 38 years (SD: 9.5). Also, 66 (27.9%) were employed while 125 (52.7%) were self-employed and 46(19.41%) unemployed. 246 (98.0%) of the participants were retained in care. While there was no statistically significant change in the CD4 counts (456cells/mm3 vs 481cells/mm3 P-0.489) and Log10 viral load (3.54c/ml vs 3.69c/ml P-0.359) after one year of devolvement into the community, we observed a significant increase in body weight (60.8 vs 65, P-0.01).

Conclusion: This study demonstrates that community antiretroviral therapy has a potential of maintaining optimum treatment outcomes while improving adherence and retention, and reducing the burden of HIV treatment on the health facility. This study provides baseline information for further research and vital information for HIV program implementers planning to decentralize the management of stable antiretroviral therapy clients.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that competing interest exist.

Figures

Fig 1
Fig 1. Pictograph of community antiretroviral group selection outcomes.
Fig 2
Fig 2. Summary of test uptake against results after one year of follow-up.
Fig 3
Fig 3. Summary of test results after one year of follow-up.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. W.H.O. Antiretroviral therapy: Who.int.; 2013 [https://www.who.int/hiv/topics/treatment/art/en/.
    1. Mukumbang F, Van Belle S, Marchal B, Van Wyk B. An exploration of group-based HIV/AIDS treatment and care models in Sub-Saharan Africa using a realist evaluation (Intervention-Context-Actor-Mechanism-Outcome) heuristic tool: a systematic review. Impl Sci. 2017;12(1):107. 10.1186/s13012-017-0638-0 - DOI - PMC - PubMed
    1. Hiko D, Jemal A, Sudhakar M, Kerie M, Degene T. Determinants of non-compliance to Antiretroviral Therapy among adults living with HIV/AIDS: A Systematic Review. JBI Libr Syst Rev. 2012;10(56):3596–648. 10.11124/01938924-201210560-00001 - DOI - PubMed
    1. Paterson DL, Swindells S, Mohr J, Brester M, Vergis EN, Squier C. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133(1):21–30. 10.7326/0003-4819-133-1-200007040-00004 - DOI - PubMed
    1. Iacob S, Iacob D, Jugulete G. Improving the Adherence to Antiretroviral Therapy, a Difficult but Essential Task for a Successful HIV Treatment—Clinical Points of View and Practical Considerations. Front Pharm. 2017;8. 10.3389/fphar.2017.00831 - DOI - PMC - PubMed

Substances