Assessing the impact of HIV support groups on antiretroviral therapy adherence and viral suppression in the African cohort study

Michael Iroezindu,Trevor A Crowell ,Hannah Kibuuka,Abdulwasiu Bolaji Tiamiyu,Nicole Dear,Allahna Esber ,John Owuoth,Domonique Reed,Yakubu Adamu,Jonah Maswai,Prudence Mbah,Christina S. Polyak ,Samirah Sani Mohammed,Julie A Ake ,Emmanuel Bahemana

doi:10.1186/s12879-021-06390-3

Abstract

BackgroundSupport groups for people living with HIV (PLWH) may improve HIV care adherence and outcomes. We assessed the impact of support group attendance on antiretroviral therapy (ART) adherence and viral suppression in four African countries.MethodsThe ongoing African Cohort Study (AFRICOS) enrolls participants at 12 clinics in Kenya, Uganda, Tanzania, and Nigeria. Self-reported attendance of any support group meetings, self-reported ART adherence, and HIV RNA are assessed every 6 months. Logistic regression models with generalized estimating equations were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for support group attendance and other factors potentially associated with ART adherence and viral suppression.ResultsFrom January 2013 to December 1, 2019, 1959 ART-experienced PLWH were enrolled and 320 (16.3%) reported any support group attendance prior to enrollment. Complete ART adherence, with no missed doses in the last 30 days, was reported by 87.8% while 92.4% had viral suppression <1000copies/mL across all available visits. There was no association between support group attendance and ART adherence in unadjusted (OR 1.01, 95% CI 0.99–1.03) or adjusted analyses (aOR 1.00, 95% CI 0.98–1.02). Compared to PLWH who did not report support group attendance, those who did had similar odds of viral suppression in unadjusted (OR 0.99, 95% CI 0.978–1.01) and adjusted analyses (aOR 0.99, 95% CI 0.97–1.01).ConclusionSupport group attendance was not associated with significantly improved ART adherence or viral suppression, although low support group uptake may have limited our ability to detect a statistically significant impact.

Highlights

Support groups for people living with human immunodeficiency virus (HIV) (PLWH) may improve HIV care adherence and outcomes
A combination of tenofovir/lamivudine/ efavirenz [TLE] (47.5%) was the most common antiretroviral therapy (ART) regimen followed by zidovudine/nevirapine/lamivudine [AZT/NVP/3TC] (25.2%), while 6.9% of participants were on a PI-based regimen
There was no association between support group attendance and ART adherence in unadjusted and adjusted analyses (Table 2)

Summary

Introduction

Support groups for people living with HIV (PLWH) may improve HIV care adherence and outcomes. The literature is replete with studies that have evaluated the impact of support group participation on psychosocial aspects of HIV care [9,10,11,12,13] In these prior studies, HIV support group attendance was found to be an effective intervention for reducing stigma, discrimination, depression, and for achieving higher levels of active coping, self-esteem, better adjustment to one’s HIV status as well as better management of partner’s reaction to disclosure [9, 11, 12]. In the context of scaling up of ART in SSA and the ‘95–95-95 targets’, looking beyond potential psychosocial benefits by assessing the impact of HIV support groups on ART adherence and treatment outcomes is crucial

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Discussion

Conclusion