AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #363 - Effect of peer health workers on AIDS care in Rakai, Uganda
Authors: Presenting Author: Ms Dorothy Mubuuke - Makerere University
Additional Authors:
Aim: The major aim was to find out the effect of peer health workers on AIDS Care in Rakai district.
Method / Issue: A cluster random sampling was used to collect data on assessment of the effect of community-based peer health workers on AIDS care of adults in Rakai, Uganda.15 AIDS clinics were randomized 2:1 to receive the Primary health worker intervention (n = 10) or control (n = 5).
Results / Comments: Primary health workers tasks included clinic and home-based provision of counseling, clinical, adherence to ART, and social support. Primary outcomes were adherence and cumulative risk of virologic failure. Secondary outcomes were virologic failure at each 24 week time point up to 192 weeks of ART. Analysis was by intention to treat.1336 patients were followed. 444 (33%) of these patients were already on ART at the start of the study. No significant differences were found in lack of adherence 95% pill count adherence risk ratio , , cumulative risk of virologic failure was 95% or in shorter-term virologic outcomes (24 week virologic failure RR 0.93, 95% CI 0.65–1.32; 48 week, RR 0.83, 95% CI 0.47–1.48; 72 week, RR 0.81, 95% CI 0.44–1.49). However, virologic failure rates ≥96 weeks into ART were significantly decreased in the intervention arm compared to the control arm (96 week failure RR 0.50, 95% CI 0.31–0.81; 120 week, RR 0.59, 95% CI 0.22–1.60; 144 week, RR 0.39, 95% CI 0.16–0.95; 168 week, RR 0.30, 95% CI 0.097–0.92; 192 week, RR 0.067, 95% CI 0.0065–0.71).
Discussion: A Primary health worker intervention was associated with decreased virologic failure rates occurring 96 weeks and longer into ART, but did not affect cumulative risk of virologic failure, adherence measures, or shorter-term virologic outcomes. PHWs may be an effective intervention to sustain long-term ART in low-resource settings.
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