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

Background: Sub-optimal adherence to antiretroviral therapy (ART) is reportedly worse amongst young people living with HIV (YPLHIV). Group adherence counselling can be useful to improve adherence. Objectives: We evaluated an enhanced adherence counselling group intervention (EACGI) amongst YPLHIV f...

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Autores principales:	Bahati Kasimonje, Tinei Shamu, Tinahe Mudzviti, Ruedi Luethy
Formato:	article
Lenguaje:	EN
Publicado:	AOSIS 2021
Materias:	enhanced adherence counselling adolescents mental health antiretroviral therapy virological failure Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/a87f295abf2a4f68876bc6b029cfc085
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spelling	oai:doaj.org-article:a87f295abf2a4f68876bc6b029cfc0852021-11-24T07:47:22ZGroup counselling for adherence support among young people failing first-line antiretroviral therapy in Zimbabwe1608-96932078-675110.4102/sajhivmed.v22i1.1292https://doaj.org/article/a87f295abf2a4f68876bc6b029cfc0852021-10-01T00:00:00Zhttps://sajhivmed.org.za/index.php/hivmed/article/view/1292https://doaj.org/toc/1608-9693https://doaj.org/toc/2078-6751Background: Sub-optimal adherence to antiretroviral therapy (ART) is reportedly worse amongst young people living with HIV (YPLHIV). Group adherence counselling can be useful to improve adherence. Objectives: We evaluated an enhanced adherence counselling group intervention (EACGI) amongst YPLHIV failing a non-nucleoside reverse transcriptase (NNRTI)-based first-line ART regimen. Method: This was a retrospective cohort study using routinely collected data of YPLHIV failing NNRTI-based first-line ART. Patients with confirmed virological failure were referred for EACGI, a 12-week curriculum of weekly, 1.5-h sessions accommodating 8–15 people per group. It aimed to facilitate readiness to switch to second-line ART and improve adherence through a mental health intervention. Viral loads of HIV were measured pre-EACGI; at baseline; 3, 6 and 12 months post switch. Results: Fifty-seven patients aged 13–25 years were invited to EACGI and followed for up to 48 weeks. Thirty-three (58%) patients attended at least four sessions, whilst 24 (42%) attended none. Amongst those who attended none, two (8%) were transferred out, three (13%) were lost to follow-up and two (8%) had died by week 48 of follow-up, whilst all who attended were still in care. By week 48, amongst patients still in care, 29%, 44% and 67% of those who attended no sessions, 4–9 and 10–12 sessions, respectively, had viral loads of 50 copies/mL. Conclusion: An EACGI is a promising intervention for YPLHIV failing ART prior to treatment switch, leading to improved adherence. This study’s findings support the need for further enquiry into rigorous, evidence-based multilevel adherence interventions that are acceptable and effective for YPLHIV.Bahati KasimonjeTinei ShamuTinahe MudzvitiRuedi LuethyAOSISarticleenhanced adherence counsellingadolescentsmental healthantiretroviral therapyvirological failurePublic aspects of medicineRA1-1270ENSouthern African Journal of HIV Medicine, Vol 22, Iss 1, Pp e1-e7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	enhanced adherence counselling adolescents mental health antiretroviral therapy virological failure Public aspects of medicine RA1-1270
spellingShingle	enhanced adherence counselling adolescents mental health antiretroviral therapy virological failure Public aspects of medicine RA1-1270 Bahati Kasimonje Tinei Shamu Tinahe Mudzviti Ruedi Luethy Group counselling for adherence support among young people failing first-line antiretroviral therapy in Zimbabwe
description	Background: Sub-optimal adherence to antiretroviral therapy (ART) is reportedly worse amongst young people living with HIV (YPLHIV). Group adherence counselling can be useful to improve adherence. Objectives: We evaluated an enhanced adherence counselling group intervention (EACGI) amongst YPLHIV failing a non-nucleoside reverse transcriptase (NNRTI)-based first-line ART regimen. Method: This was a retrospective cohort study using routinely collected data of YPLHIV failing NNRTI-based first-line ART. Patients with confirmed virological failure were referred for EACGI, a 12-week curriculum of weekly, 1.5-h sessions accommodating 8–15 people per group. It aimed to facilitate readiness to switch to second-line ART and improve adherence through a mental health intervention. Viral loads of HIV were measured pre-EACGI; at baseline; 3, 6 and 12 months post switch. Results: Fifty-seven patients aged 13–25 years were invited to EACGI and followed for up to 48 weeks. Thirty-three (58%) patients attended at least four sessions, whilst 24 (42%) attended none. Amongst those who attended none, two (8%) were transferred out, three (13%) were lost to follow-up and two (8%) had died by week 48 of follow-up, whilst all who attended were still in care. By week 48, amongst patients still in care, 29%, 44% and 67% of those who attended no sessions, 4–9 and 10–12 sessions, respectively, had viral loads of 50 copies/mL. Conclusion: An EACGI is a promising intervention for YPLHIV failing ART prior to treatment switch, leading to improved adherence. This study’s findings support the need for further enquiry into rigorous, evidence-based multilevel adherence interventions that are acceptable and effective for YPLHIV.
format	article
author	Bahati Kasimonje Tinei Shamu Tinahe Mudzviti Ruedi Luethy
author_facet	Bahati Kasimonje Tinei Shamu Tinahe Mudzviti Ruedi Luethy
author_sort	Bahati Kasimonje
title	Group counselling for adherence support among young people failing first-line antiretroviral therapy in Zimbabwe
title_short	Group counselling for adherence support among young people failing first-line antiretroviral therapy in Zimbabwe
title_full	Group counselling for adherence support among young people failing first-line antiretroviral therapy in Zimbabwe
title_fullStr	Group counselling for adherence support among young people failing first-line antiretroviral therapy in Zimbabwe
title_full_unstemmed	Group counselling for adherence support among young people failing first-line antiretroviral therapy in Zimbabwe
title_sort	group counselling for adherence support among young people failing first-line antiretroviral therapy in zimbabwe
publisher	AOSIS
publishDate	2021
url	https://doaj.org/article/a87f295abf2a4f68876bc6b029cfc085
work_keys_str_mv	AT bahatikasimonje groupcounsellingforadherencesupportamongyoungpeoplefailingfirstlineantiretroviraltherapyinzimbabwe AT tineishamu groupcounsellingforadherencesupportamongyoungpeoplefailingfirstlineantiretroviraltherapyinzimbabwe AT tinahemudzviti groupcounsellingforadherencesupportamongyoungpeoplefailingfirstlineantiretroviraltherapyinzimbabwe AT ruediluethy groupcounsellingforadherencesupportamongyoungpeoplefailingfirstlineantiretroviraltherapyinzimbabwe
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Group counselling for adherence support among young people failing first-line antiretroviral therapy in Zimbabwe

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