TY - JOUR
T1 - Determinants of engagement in HIV treatment and care among zambians new to antiretroviral therapy
AU - Jones, Deborah L.
AU - Zulu, Isaac
AU - Vamos, Szonja
AU - Cook, Ryan
AU - Chitalu, Ndashi
AU - Weiss, Stephen M.
N1 - Funding Information:
The authors would like to thank the nurses, physicians, and patients participating in the study, without whom the study would not have been possible. This study was supported by a National Institute of Allergy & Infectious Diseases grant, no. R21AI067115 .
PY - 2013/9
Y1 - 2013/9
N2 - This pilot study assessed the determinants of engagement in HIV care among Zambian patients new to antiretroviral (ARV) therapy, and the effect of an intervention to increase medication adherence. Participants ( n=160) were randomized to a 3-month group or individual intervention utilizing a crossover design. Psychophysiological (depression, cognitive functioning, health status), social (social support, disclosure, stigma), structural factors (health care access, patient-provider communication), and treatment engagement (adherence to clinic visits and medication) were assessed. Participants initially receiving the group intervention improved their adherence, but gains were not maintained following crossover to the individual intervention. Increased social support and patient-provider communication and decreased concern about HIV medications predicted increased clinic attendance across both arms. Results suggest that early participation in a group intervention may promote increased adherence among patients new to ARV therapy, but long-term engagement in care may be sustained by both one-on-one and group interventions by health care staff.
AB - This pilot study assessed the determinants of engagement in HIV care among Zambian patients new to antiretroviral (ARV) therapy, and the effect of an intervention to increase medication adherence. Participants ( n=160) were randomized to a 3-month group or individual intervention utilizing a crossover design. Psychophysiological (depression, cognitive functioning, health status), social (social support, disclosure, stigma), structural factors (health care access, patient-provider communication), and treatment engagement (adherence to clinic visits and medication) were assessed. Participants initially receiving the group intervention improved their adherence, but gains were not maintained following crossover to the individual intervention. Increased social support and patient-provider communication and decreased concern about HIV medications predicted increased clinic attendance across both arms. Results suggest that early participation in a group intervention may promote increased adherence among patients new to ARV therapy, but long-term engagement in care may be sustained by both one-on-one and group interventions by health care staff.
KW - Behavioral intervention
KW - Engagement in care
KW - HIV
KW - Medication adherence
KW - Zambia
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U2 - 10.1016/j.jana.2012.06.009
DO - 10.1016/j.jana.2012.06.009
M3 - Article
C2 - 23009738
AN - SCOPUS:84882625472
SN - 1055-3290
VL - 24
SP - e1-e12
JO - Journal of the Association of Nurses in AIDS Care
JF - Journal of the Association of Nurses in AIDS Care
IS - 5
ER -