Effect and Implementation experience of intensive adherence couns | 60585
HIV: Current Research

HIV: Current Research
Open Access

ISSN: 2572-0805

Effect and Implementation experience of intensive adherence counseling in a public HIV care center in Uganda: a Mixed-methods study

Global Summit on HIV-AIDS and STDs

April 28-29, 2022 | Webinar

Zubair Lukyamuzi

Makerere University, Uganda

Scientific Tracks Abstracts: HIV Curr Res

Abstract :

Intensive adherence counseling (IAC) is recommended in HIV care to improve ART adherence among PLHIV on ART with unsuppressed viral load (VL). Using sequential explanatory mixed-methods; we evaluated the effect of providing IAC by comparing VL suppression during IAC implementation to the period before IAC in an urban HIV care center Kampala, Uganda. The effect of IAC on VL suppression and associated factors were analyzed using modified Poisson regression with robust standard errors. We used in-depth interviews and an inductive analysis approach in Atlas. ti 8 to explore the experiences of providing IAC among healthcare workers (HCW). A total of 500 records were sampled, 249 (49.8%) in IAC implementation period and 251 (51.2%) in the period before IAC. 325/500 (65.0%) received IAC across the study periods, and of these 249/325 (76.6%) were in the period of IAC. Among those who received IAC, 143/325 (44.1%) achieved viral suppression compared to 46/175 (26.3%) who did not receive IAC. Receiving IAC significantly increased VL suppression by 22% (aPR = 1.22, 95% CI: 1.01–1.47). Clients on Protease-based regimen were less likely to suppress than those on Efavirenz or Nevirapine based regimens (aPR= 0.11, 95%CI: 0.08–0.15). HCW commended IAC for improving ART adherence. However, patient and health care system related factors undermined its effect. The full potential of IAC has not been reached in this setting due to the above related factors. Therefore, provision of adequate IAC necessities and use of patient centered approaches may maximise the potential of the intervention.

Biography :

Dr. Zubair, MBChB, MPH is an early investigator at MU-JHU care limited with WHO training in implementation Research on Infectious Diseases of Poverty (IDP). He is a fogarty fellow who has been an independent investigator on an NIH Fogarty grant #D43TW009340 looking at the “role of CHW in facilitating disclosure among adults living with HIV in heterosexual partnerships”. Dr. Zubair has a great passion in interventional research and is currently serving as a co-investiagtor on an NIH funded grant looking at a novel video-based intervention to enhance optimal uptake of malaria preventive therapy in preganat HIV positive and negative women.

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