ART Adherence Among Malawian Youth Enrolled in Teen Clubs: A Retrospective Chart Review

McBride, Kaitlyn; Parent, Julie; Mmanga, Kondwani; Chivwala, Mackenzie; Nyirenda, Mike; Schooley, Alan; Mwambene, J B; Dovel, Kathryn; Lungu, Eric; Balakasi, Kelvin; Hoffman, Risa M.; Moucheraud, Corrina

doi:10.1007/s10461-019-02580-y

Cited by 23 publications

(30 citation statements)

References 15 publications

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“…5 However, there remain significant gaps in HIV testing and treatment, particularly among young adults. [6][7][8] Despite scientific consensus on the efficacy of TasP, little is known about the diffusion of TasP information to young adults in countries where HIV is endemic. Studies have found increases in TasP knowledge in the 2010s among male sexual minority populations in North America, Europe and Australia.…”

Section: Introductionmentioning

confidence: 99%

Perceived efficacy of HIV treatment-as-prevention among university students in Johannesburg, South Africa

et al. 2021

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ObjectiveAntiretroviral therapy (ART) nearly eliminates HIV transmission. Yet information on treatment as prevention (TasP) has been slow to diffuse in sub-Saharan Africa. We assessed TasP knowledge among university students in South Africa.MethodsWe conducted a cross-sectional survey of first-year university students at a large public university in Johannesburg, South Africa, all of whom would have recently completed secondary school HIV curricula. Respondents were asked to consider the likelihood of HIV transmission in a serodiscordant couple having condomless sex with and without virally suppressive ART. Beliefs were elicited using a 0–20 visual scale. Perceived TasP efficacy was computed as the relative reduction in risk associated with virally suppressive ART. We compared beliefs with estimates from the scientific literature and assessed associations with demographics, HIV testing history and qualitative measures of HIV knowledge and risk perception.ResultsThe analysis included 365 university students ages 18-25 years (48% female, 56% from Gauteng Province). On average, perceived annual risk of HIV transmission with virally suppressive ART was 73%; the objective risk is <1%. On average, respondents perceived that virally suppressive ART reduced annual transmission risk by 17%; the objective reduction in risk is >96%. We observed no differences in perceived TasP efficacy by participant characteristics and testing history. Perceived TasP efficacy was correlated with the (correct) belief that HIV risk increases with sexual frequency.ConclusionsUniversity students in South Africa underestimated the prevention benefits of HIV treatment. Low knowledge of TasP could limit demand for HIV testing and treatment among young adults.

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Section: Introductionmentioning

confidence: 99%

Perceived efficacy of HIV treatment-as-prevention among university students in Johannesburg, South Africa

et al. 2021

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“…ALHIV aged 15–19 years were more likely to have attrition from care than those aged 10–14 years (aOR 2.14; 95% CI 1.12, 4.11) [ 16 ]. Another evaluation in Malawi of a similar teen club intervention reported in 2019 on adherence levels between younger and older adolescents and male and female adolescents found that older adolescence were associated with higher odds of optimal adherence compared to younger adolescents (aOR 1.48; 95% CI 1.16–1.90, p < 0.01) [ 17 ]. Evaluations of teen clubs have been scarce, and both Malawi studies recommended age-specialized programming for adolescents and argued that more prospective research is required with higher methodological quality.…”

Section: Introductionmentioning

confidence: 99%

The Comparison of Teen Clubs vs. Standard Care on Treatment Outcomes for Adolescents on Antiretroviral Therapy in Windhoek, Namibia

Munyayi

Wyk

2020

AIDS Research and Treatment

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Background. Adolescents living with HIV (ALHIV) are challenged to adhere to antiretroviral therapy (ART) and achieve and maintain virologic suppression. Group-based adherence support interventions, such as adherence clubs, have been shown to improve long-term adherence in ART patients. The teen club intervention was introduced in 2010 in Namibia to improve treatment outcomes for ALHIV by providing adherence support in a peer-group environment. Adolescents who have completed the full HIV disclosure process can voluntarily join the teen clubs. The current study compared treatment outcomes of ALHIV receiving ART at a specialized paediatric HIV clinic between 1 July 2015 and 30 June 2017 in Windhoek, Namibia. Methods. A retrospective cohort analysis was conducted on routine patient data extracted from the electronic Patient Monitoring System, individual Patient Care Booklets, and teen club attendance registers. A sample of 385 adolescents were analysed: 78 in teen clubs and 307 in standard care. Virologic suppression was determined at 6, 12, and 18 months from study start date, and compared by model of care, age, sex, disclosure status, and ART regimen. Comparisons between adolescents in teen clubs and those receiving standard care were performed using the chi-square test, and risk ratios were calculated to analyze differences in ART adherence and virologic suppression. Results. The average clinician-measured ART adherence was 89% good, 6% fair, and 5% poor amongst all adolescents, with no difference between teen club members and adolescents in standard care ( p = 0.277) at 3 months. Virologic suppression over the 2-year observation period was 87% (68% fully suppressed <40 copies/ml and 19% suppressed between 40–999 copies/ml), with no difference between teen club members and those in standard care. However, there were statistically significant differences in virologic suppression levels between the younger (10–14 years) adolescents and older (15–19 years) adolescents at 6 months ( p = 0.015) and at 12 months ( p = 0.021) and between adolescents on first-line and second-line ART regimen at 6 months ( p = 0.012), 12 months ( p = 0.004), and 18 months ( p = 0.005). Conclusion. The teen club model delivering psychosocial support only did not improve adherence and virologic suppression levels for adolescents in a specialized paediatric ART clinic, neither were they inferior to standard care. Considering the limitations of this study, teen clubs may still hold potential for improving adherence and virologic suppression levels for older adolescents, and more robust research on adherence interventions for adolescents with higher methodological quality is required.

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“…These clubs have been rolled out and evaluated in a few treatment programmes around Africa. 32 Adolescents receiving care and enrolled in teen clubs in Windhoek, Namibia, did not show improved treatment outcomes compared, with the standard of care. 33 Whilst there was marginal improvement in adherence (adjusted odds ratio [aOR]: 1.48, 95% CI: 1.16–1.90, p < 0.01) to ART in a Malawian study utilising teen clubs.…”

Section: Discussionmentioning

confidence: 94%

“… 33 Whilst there was marginal improvement in adherence (adjusted odds ratio [aOR]: 1.48, 95% CI: 1.16–1.90, p < 0.01) to ART in a Malawian study utilising teen clubs. 32 The introduction of an EACGI, which has shown positive results in the Zimbabwean setting, could very well complement the differentiated models being rolled out for young people requiring adherence support.…”

Section: Discussionmentioning

confidence: 99%

Group counselling for adherence support among young people failing first-line antiretroviral therapy in Zimbabwe

Kasimonje¹,

Shamu

Mudzviti

et al. 2021

Southern African Journal of HIV Medicine

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ART Adherence Among Malawian Youth Enrolled in Teen Clubs: A Retrospective Chart Review

Cited by 23 publications

References 15 publications

Perceived efficacy of HIV treatment-as-prevention among university students in Johannesburg, South Africa

Perceived efficacy of HIV treatment-as-prevention among university students in Johannesburg, South Africa

The Comparison of Teen Clubs vs. Standard Care on Treatment Outcomes for Adolescents on Antiretroviral Therapy in Windhoek, Namibia

Group counselling for adherence support among young people failing first-line antiretroviral therapy in Zimbabwe

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