A Cluster-Randomized Controlled Trial of an Economic Strengthening Intervention to Enhance Antiretroviral Therapy Adherence among Adolescents Living with HIV.
A Cluster-Randomized Controlled Trial of an Economic Strengthening Intervention to Enhance Antiretroviral Therapy Adherence among Adolescents Living with HIV.
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DOI：
10.1007/s10461-024-04268-4
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发表时间：
2024-01-17
影响因子：
4.4
通讯作者：
Ssewamala，Fred M.
中科院分区：
文献类型：
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作者：
Kizito，Samuel;Namuwonge，Flavia;Ssewamala，Fred M.
我们研究了经济赋权干预对艾滋病毒感染者抗逆转录病毒治疗依从性的影响。我们使用来自455名ALHIV患者的数据，随机分为干预组，n= 111，对照组= 344。在2013年1月至2015年12月期间，他们从乌干达的39家诊所招募了12-16岁的ALHIV患者。干预措施包括长期儿童发展帐户、微型企业讲习班和教育会议。依从性是用未公布的药丸数来衡量的。我们使用混合效应逻辑回归分析来检验干预对ART依从性的影响。平均年龄为12.6岁。尽管观察到组间主效应不显著，但我们发现组间时间交互效应显著χ2(5) = 45.41,p< 0.001。两两比较显示，与对照组相比，接受干预的参与者在第4次就诊时的依从性显著更高，OR = 1.52 (95% CI: 1.07-2.18),p= 0.020；访问五,或= 1.59(95%置信区间:1.06—-2.38),p = 0.026;和访问6、或= 1.94(95%置信区间:1.24—-3.04),p = 0.004。支持艾滋病毒感染者延长寿命和健康生活的努力应纳入解决贫困问题的组成部分。然而，依从性的下降引起了对ALHIV长期健康的担忧。该试验已在ClinicalTrials.gov注册，注册号NCT01790373，主要结局是坚持HIV治疗。
We examined the impact of an economic empowerment intervention on ART adherence among ALHIV. We used data from 455 ALHIV, randomized into intervention,n= 111, and controln= 344. ALHIV were aged 12–16 and recruited from 39 clinics in Uganda between January 2013 and December 2015. The intervention comprised a long-term child development account (CDA), micro-enterprise workshops, and educational sessions. Adherence was measured using unannounced pill counts. We used mixed-effects logistic regression analysis to examine the effect of the intervention on ART adherence. The mean age was 12.6 years. Despite observing non-significant group main effects, we found significant group-by-time interaction effects χ2(5) = 45.41,p< 0.001. Pairwise comparisons showed that compared to the control group, participants who received the intervention had significantly higher adherence at visit four, OR = 1.52 (95% CI: 1.07–2.18),p= 0.020; visit five, OR = 1.59 (95% CI: 1.06–2.38),p= 0.026; and visit six, OR = 1.94 (95% CI: 1.24–3.04),p= 0.004. Efforts to support ALHIV to live longer and healthier lives should incorporate components addressing poverty. However, declining adherence raises concerns over ALHIV’s long-term well-being. The trial was registered at ClinicalTrials.gov, registration number NCT01790373, with a primary outcome of adherence to HIV treatment.