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An Observational Cohort Comparison of Facilitators of Retention in Care and Adherence to Anti-Eetroviral Therapy at an HIV Treatment Center in Kenya

Author

Listed:
  • Loice Achieng
  • Helen Musangi
  • Sharon Ong'uti
  • Edwin Ombegoh
  • LeeAnn Bryant
  • Jonathan Mwiindi
  • Nathaniel Smith
  • Philip Keiser

Abstract

Background: Most HIV treatment programs in resource-limited settings utilize multiple facilitators of adherence and retention in care but there is little data on the efficacy of these methods. We performed an observational cohort analysis of a treatment program in Kenya to assess which program components promote adherence and retention in HIV care in East Africa. Methods: Patients initiating ART at A.I.C. Kijabe Hospital were prospectively enrolled in an observational study. Kijabe has an intensive program to promote adherence and retention in care during the first 6 months of ART that incorporates the following facilitators: home visits by community health workers, community based support groups, pharmacy counseling, and unannounced pill counts by clinicians. The primary endpoint was time to treatment failure, defined as a detectable HIV-1 viral load; discontinuation of ART; death; or loss to follow-up. Time to treatment failure for each facilitator was calculated using Kaplan-Meier analysis. The relative effects of the facilitators were determined by the Cox Proportional Hazards Model. Results: 301 patients were enrolled. Time to treatment failure was longer in patients participating in support groups (448 days vs. 337 days, P

Suggested Citation

  • Loice Achieng & Helen Musangi & Sharon Ong'uti & Edwin Ombegoh & LeeAnn Bryant & Jonathan Mwiindi & Nathaniel Smith & Philip Keiser, 2012. "An Observational Cohort Comparison of Facilitators of Retention in Care and Adherence to Anti-Eetroviral Therapy at an HIV Treatment Center in Kenya," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-7, March.
    • Handle: RePEc:plo:pone00:0032727
    DOI: 10.1371/journal.pone.0032727
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    References listed on IDEAS

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    1. Ziad El-Khatib & David Katzenstein & Gaetano Marrone & Fatima Laher & Lerato Mohapi & Max Petzold & Lynn Morris & Anna Mia Ekström, 2011. "Adherence to Drug-Refill Is a Useful Early Warning Indicator of Virologic and Immunologic Failure among HIV Patients on First-Line ART in South Africa," PLOS ONE, Public Library of Science, vol. 6(3), pages 1-10, March.
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    Cited by:

    1. Panmial Priscilla Damulak & Suriani Ismail & Rosliza Abdul Manaf & Salmiah Mohd Said & Oche Agbaji, 2021. "Interventions to Improve Adherence to Antiretroviral Therapy (ART) in Sub-Saharan Africa: An Updated Systematic Review," IJERPH, MDPI, vol. 18(5), pages 1-21, March.

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    1. Loice Achieng & Helen Musangi & Katherine Billingsley & Sharon Onguit & Edwin Ombegoh & LeeAnn Bryant & Jonathan Mwiindi & Nathaniel Smith & Philip Keiser, 2013. "The Use of Pill Counts as a Facilitator of Adherence with Antiretroviral Therapy in Resource Limited Settings," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-1, December.

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