Process evaluation of an intervention to improve HIV treatment outcomes among children and adolescents.

Autor:	Seguin M; Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK., Dringus S; Global Health Department, London School of Hygiene and Tropical Medicine, London, UK., Chiomvu S; Million Memory Project Zimbabwe, Bulawayo, Zimbabwe., Apollo T; AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe., Sibanda E; Health Services Department, Bulawayo City Health, Bulawayo, Zimbabwe., Simms V; Biomedical Research and Training Institute, Harare, Zimbabwe.; International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK., Bernays S; Global Health Department, London School of Hygiene and Tropical Medicine, London, UK.; School of Public Health, University of Sydney, Sydney, NSW, Australia., Chikodzore R; Ministry of Health and Child Care, Gwanda, Zimbabwe., Redzo N; Biomedical Research and Training Institute, Harare, Zimbabwe., Mlilo P; Biomedical Research and Training Institute, Harare, Zimbabwe., Ndlovu L; Biomedical Research and Training Institute, Harare, Zimbabwe., Nzombe P; Biomedical Research and Training Institute, Harare, Zimbabwe., Ncube B; Biomedical Research and Training Institute, Harare, Zimbabwe., Kranzer K; Biomedical Research and Training Institute, Harare, Zimbabwe.; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.; Division of Infectious and Tropical Medicine, Medical Centre of the University of Munich, Munich, Germany., Abbas Ferrand R; Biomedical Research and Training Institute, Harare, Zimbabwe.; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK., Chikwari CD; Biomedical Research and Training Institute, Harare, Zimbabwe.; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
Jazyk:	angličtina
Zdroj:	Public health action [Public Health Action] 2022 Sep 21; Vol. 12 (3), pp. 108-114.
DOI:	10.5588/pha.22.0009
Abstrakt:	Setting: Children and adolescents with HIV encounter challenges in initiation and adherence to antiretroviral therapy (ART). A community-based support intervention of structured home visits, aimed at improving initiation, adherence and treatment, was delivered by community health workers (CHWs) to children and adolescents newly diagnosed with HIV. Objectives: To 1) describe intervention delivery, 2) explore CHW, caregiver and adolescents' perceptions of the intervention, 3) identify barriers and facilitators to implementation, and 4) ascertain treatment outcomes at 12 months' post-HIV diagnosis. Design: We drew upon: 1) semi-structured interviews ( n = 22) with 5 adolescents, 11 caregivers and 6 CHWs, 2) 28 CHW field manuals, and 3) quantitative data for study participants (demographic information and HIV clinical outcomes). Results: Forty-one children received at least a part of the intervention. Of those whose viral load was tested, 26 ( n = 32, 81.3%) were virally suppressed. Interviewees felt that the intervention supported ART adherence and strengthened mental health. Facilitators to intervention delivery were convenience and rapport between CHWs and families. Stigma, challenges in locating participants and inadequate resources for CHWs were barriers. Conclusion: This intervention was helpful in supporting HIV treatment adherence among adolescents and children. Facilitators and barriers may be useful in developing future interventions.
Databáze:	MEDLINE
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