Effect of Text Messaging Plus Peer Navigation on Viral Suppression Among Youth With HIV in the iCARE Nigeria Pilot Study.
Effect of Text Messaging Plus Peer Navigation on Viral Suppression Among Youth With HIV in the iCARE Nigeria Pilot Study.
复制标题
DOI：
10.1097/qai.0000000000002694
复制
发表时间：
2021-08-01
期刊：
影响因子：
--
通讯作者：
Garofalo R
中科院分区：
文献类型：
--
作者：
Taiwo BO;Kuti KM;Kuhns LM;Omigbodun O;Awolude O;Adetunji A;Berzins B;Janulis P;Johnson AK;Okonkwor O;Oladeji BD;Muldoon A;Adewumi OM;Amoo P;Atunde H;Kapogiannis B;Garofalo R
与全球趋势一致，尼日利亚青年艾滋病毒感染者（YWH）的病毒未抑制率很高。需要新的干预措施。尼日利亚伊巴丹大学医学院传染病研究所。在一项单组试验中，15-24岁的参与者接受了48周的联合干预，包括每日双向短信药物提醒和同伴导航。主要结局指标为病毒抑制低于200拷贝/mL。次要结局指标包括视觉模拟量表上自我报告的依从性和药物拥有率（MPR），每项均分为≥90%（良好）或< 90%（不良）依从性。使用McNemar检验分析结果。护理保留，干预的可行性和可接受性，以及参与者的满意度也进行了评估。入组了40名YWH（50%男性）：平均年龄19.9岁（SD=2.5），55%围产期感染，35%基线时病毒学抑制。与基线相比，24周（OR = 14.00，p < 0.001）和48周（OR = 6.00，p = 0.013）时病毒学抑制的几率更高。第24周（63%，p = 0.008）和第48周（68%，p = 0.031）时自我报告的依从性（≥90%）较基线增加。第24周和第48周时，MPR增加≥90%（分别为85%和80%），仅在第24周时达到统计学显著性（p = 0.022）。48周时的护理保留率为87.5%。在第48周，所有（37/37）参与者对干预完全或大部分满意。每日双向短信提醒加上同伴导航是一种有希望的组合干预措施，可以改善尼日利亚YWH中的病毒抑制。
Consistent with the global trend, youth with HIV (YWH) in Nigeria have high rates of viral non-suppression. Novel interventions are needed. Infectious Diseases Institute, College of Medicine, University of Ibadan, Nigeria. In a single-arm trial, participants aged 15–24 years old received 48 weeks of a combination intervention, comprising daily two-way text message medication reminders plus peer navigation. The primary outcome measure was viral suppression below 200 copies/mL. Secondary outcomes measures included self-reported adherence on a visual analogue scale and medication possession ratio (MPR), each dichotomized as ≥90% (good) or < 90% (poor) adherence. Outcomes were analyzed using McNemar’s test. Retention in care, intervention feasibility and acceptability, and participants’ satisfaction were also assessed. Forty YWH (50% male) were enrolled: mean age 19.9 years (SD=2.5), 55% perinatally-infected, and 35% virologically suppressed at baseline. Compared to baseline, the odds of virologic suppression was higher at 24 weeks (OR = 14.00, p < 0.001) and 48 weeks (OR = 6.00, p = 0.013). Self-reported adherence (≥90%) increased from baseline at 24 weeks (63%, p = 0.008) and 48 weeks (68%, p = 0.031). MPR ≥90% increased at weeks 24 and 48 (85% and 80%, respectively), achieving statistical significance at 24 weeks only (p = 0.022). Retention in care at 48 weeks was 87.5%. All (37/37) participants at week 48 were fully or mostly satisfied with the intervention. Daily, two-way text message reminders plus peer navigation is a promising combination intervention to improve viral suppression among YWH in Nigeria.