The effectiveness and cost-effectiveness of community-based support for adolescents receiving antiretroviral treatment: an operational research study in South Africa

Journal of the International AIDS Society
Geoffrey FattiAshraf Grimwood

Abstract

Adolescents and youth receiving antiretroviral treatment (ART) in sub-Saharan Africa have high attrition and inadequate ART outcomes, and evaluations of interventions improving ART outcomes amongst adolescents are very limited. Sustainable Development Goal (SDG) target 3c is to substantially increase the health workforce in developing countries. We measured the effectiveness and cost-effectiveness of community-based support (CBS) provided by lay health workers for adolescents and youth receiving ART in South Africa. A retrospective cohort study including adolescents and youth who initiated ART at 47 facilities. Previously unemployed CBS-workers provided home-based ART-related education, psychosocial support, symptom screening for opportunistic infections and support to access government grants. Outcomes were compared between participants who received CBS plus standard clinic-based care versus participants who received standard care only. Cumulative incidences of all-cause mortality and loss to follow-up (LTFU), adherence measured using medication possession ratios (MPRs), CD4 count slope, and virological suppression were analysed using multivariable Cox, competing-risks regression, generalized estimating equations and mixed-eff...Continue Reading

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Citations

May 11, 2019·Journal of the International AIDS Society·Robert GlaubiusUme L Abbas
Aug 6, 2019·Tropical Medicine & International Health : TM & IH·Geoffrey FattiAshraf Grimwood
Feb 28, 2018·Journal of the International AIDS Society·Douglas WebbChewe Luo
Mar 13, 2021·Scientific Reports·Cari van SchalkwykLeigh F Johnson

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