Barcelona 2013
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| Abstract #16 - E-Posters English | ||||
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Session: 50.95: E-Posters English (Poster) on Sunday in Chaired by Authors: Presenting Author: Professor Francis Van Loon - University of Antwerp, Belgium |
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| Additional Authors: Dr. Jordi Casabona, Sra Cristina Sanclemente, Dra. Anna Esteve, Dra. Victoria Gonzalez, Grupo HIVITS TS, | ||||
| Aim: Without sufficient attention for the psycho-social dimensions of life with HIV/AIDS as a chronic illness, it is highly unlikely that the favorable short-term results of the South African ART programs can be replicated and sustained in the upcoming decades. But, who will do the job? The inadequate supply of skilled health professionals (doctors, nurses) is deplored as the single most serious obstacle for implementing ART-programs in countries as South Africa. In this context lay adherence supporters may offer potential benefit in providing the psychological care needed to comply with treatment guidelines. In order to optimally capitalize on the beneficial impact of community-based adherence support, knowledge is also needed on factors facilitating or hampering this impact. Some studies have suggested that better family functioning can be a catalyst for better health-related outcomes in families affected by HIV/AIDS. The current study aims to address the above-cited research gaps and has two related objectives: (1) to assess the impact of peer adherence support on treatment outcomes in a randomized control experiment and (2) to explore the potential mediating role of family dynamics by assessing the differential impact of peer adherence support in four types of families based on the theoretical underpinnings of the family functioning framework. | ||||
| Method / Issue: These relationships are explored in a sample of 496 patients enrolled in the public-sector ART program of the Free State Province of South Africa. For the analysis we used stepwise logistic regression analysis and multi-group analysis. | ||||
| Results / Comments: Stepwise logistic regression analysis demonstrated no significant overall differences in treatment outcomes between the experimental group accessing additional peer adherence support and the control group receiving standard care. However, with regard to our second research aim, the study outcomes clearly support our hypothesis by demonstrating a significant interaction effect between the adherence intervention and family functioning levels. Multi-group analysis demonstrated that peer adherence support did produce a strong positive effect on immunological restoration, but only in the balanced family type with high levels of attachment and changeability. | ||||
| Discussion: These findings may have important implications for HIV/AIDS research and practice: future adherence support interventions should incorporate family functioning as these family dynamics can facilitate as well as hamper intervention effectiveness. Tailoring these interventions to the needs of these different family types is a necessity, especially for the most vulnerable patient groups, those that cannot fall back on a supportive family network. | ||||
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