The Effect of Community-Based Support Services on Clinical Efficacy and Health-Related Quality of Life in HIV/AIDS Patients in Resource-Limited Settings in Sub-Saharan Africa
- 1 September 2010
- journal article
- research article
- Published by Mary Ann Liebert Inc in AIDS Patient Care and STDs
- Vol. 24 (9), 581-594
- https://doi.org/10.1089/apc.2009.0307
Abstract
Antiretroviral therapy (ART) for HIV/AIDS in developing countries has been rapidly scaled up through directed public and private resources. Data on the efficacy of ART in developing countries are limited, as are operational research studies to determine the effect of selected nonmedical supportive care services on health outcomes in patients receiving ART. We report here on an investigation of the delivery of medical care combined with community-based supportive services for patients with HIV/AIDS in four resource-limited settings in sub-Saharan Africa, carried out between 2005 and 2007. The clinical and health-related quality of life (HRQOL) efficacy of ART combined with community support services was studied in a cohort of 377 HIV-infected patients followed for 18 months, in community-based clinics through patient interviews, clinical evaluations, and questionnaires. Patients exposed to community-based supportive services experienced a more rapid and greater overall increase in CD4 cell counts than unexposed patients. They also had higher levels of adherence, attributed primarily to exposure to home-based care services. In addition, patients receiving home-based care and/or food support services showed greater improvements in selected health-related QOL indicators. This report discusses the feasibility of effective ART in a large number of patients in resource-limited settings and the added value of concomitant community-based supportive care services.Keywords
This publication has 31 references indexed in Scilit:
- “It's all the time in my mind”: Facilitators of adherence to antiretroviral therapy in a Tanzanian settingSocial Science & Medicine, 2009
- Prolongation and quality of life for HIV-infected adults treated with highly active antiretroviral therapy (HAART): a balancing actJournal of Antimicrobial Chemotherapy, 2008
- Rapid Scale-up of Antiretroviral Therapy at Primary Care Sites in ZambiaJAMA, 2006
- The WHO public-health approach to antiretroviral treatment against HIV in resource-limited settingsThe Lancet, 2006
- Scaling up of highly active antiretroviral therapy in a rural district of Malawi: an effectiveness assessmentThe Lancet, 2006
- Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural UgandaAIDS, 2006
- Efficacy of Antiretroviral Therapy Programs in Resource‐Poor Settings: A Meta‐analysis of the Published LiteratureClinical Infectious Diseases, 2005
- Adherence to Antiretroviral Therapy in HIV-Infected Adults in Soweto, South AfricaAIDS Research and Human Retroviruses, 2004
- Promoting adherence to antiretroviral therapyAIDS, 2004
- Virologic and immunologic outcomes and programmatic challenges of an antiretroviral treatment pilot project in Abidjan, Côte dʼIvoireAIDS, 2003