A Randomized Control Trial of a Peer Adherence and Nutritional Support Program for Public Sector Antiretroviral Patients
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World Bank, Washington, DC
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Descripción
Access to antiretroviral treatment has
expanded rapidly in South Africa, making it the country in
the world with the largest treatment program. As
antiretroviral treatment coverage continues to rise in
resource-constrained settings, effective community-based
adherence support interventions are of central importance in
ensuring the long-term sustainability of treatment. This
paper reports the findings from a randomized control trial
of a peer adherence and nutritional support program
implemented in a public health care setting in South
Africa's antiretroviral treatment program. The analysis
assesses the impact of these peer adherence and nutritional
support interventions on self-reported adherence, timeliness
of clinic and hospital visits, and immunologic response to
antiretroviral treatment. Peer adherence and nutritional
support improved the timeliness of adults´ clinic and
hospital visits for routine follow-up while on
antiretroviral treatment. Peer adherence support impacted
positively on immunologic response to antiretroviral
treatment. Scale-up of effective and sustainable
community-based, peer-driven adherence and nutritional
support interventions should form part of the United Nations
AIDS Treatment 2.0 strategy's community mobilization
and health system strengthening pillar.
Palabras clave
HIV, AIDS, health, nutrition, randomized control trials, antiretroviral treatment