Effectiveness of Outreach Clinical Mentoring on Retention in Care and Viral Suppression among HIV Positive Young Persons on Art in North Central Nigeria

Abstract

Introduction Sexual and reproductive health challenges vis-à-vis Human immunodeficiency virus/Acquired immune deficiency syndrome, constitute a complex phenomenon in young persons. These health complexes have been shown to adversely affect the disclosure of their positive status, their adherence to medications or retention in care and overall quality of life. This study was meant to determine the effectiveness of deliberate clinical mentoring on retention in care, measured by the rate of interruption in treatment and viral suppression among young persons on anti-retroviral therapy.  Methods This study employed a facility-based quasi- experimental design. A multi-stage sampling technique was used to select study participants. The three senatorial zones of Nasarawa state were selected through a purposive sampling method at stage one. One Local Government Area was selected from each of the three senatorial zones through simple random sampling technique at stage two. Five health care facilities were randomly selected from each of the three selected Local Government Areas through balloting at stage three. Baseline data was collected at the beginning of the study; mid-term data mid- way into the study and post-intervention data was collected at the end of the study. The respondents/mentees were mentored for a period of eight months.  Results Difference in means of interruption in treatment rates at baseline and at midterm, which is an estimate of the amount by which intervention changed the outcome was – 0.69605 with a p-value of 0.359. Mean differences in interruption in treatment rates pre- and post-intervention was 0.7333 with a p-value of 0.033, which was statistically significant. In a similar vein, mean differences in viral suppression rates at start of study and mid-term on the one hand, and then pre- and post-intervention on the other hand, were respectively 4.80000 and 3.40000. The corresponding p-values were 0.235 and 0.174, which were not statistically significant.  Conclusion This study showed 100% retention among young persons on anti-retroviral therapy following 8 months of meticulous outreach clinical mentoring. The study also showed improvements in viral suppression rates, but the extent statistically, was not significant. Clinical mentoring should therefore, be prioritized and strengthened for better clinical care outcomes in positive young persons on anti retroviral therapy.