Community-Based Accompaniment and the Impact of Distance for HIV Patients Newly Initiated on Antiretroviral Therapy: Early Outcomes and Clinic Visit Adherence in Rural Rwanda.
AIDS Behav
; 22(1): 77-85, 2018 01.
Article
en En
| MEDLINE
| ID: mdl-28025738
ABSTRACT
Community-based accompaniment (CBA) has been associated with improved antiretroviral therapy (ART) patient outcomes in Rwanda. In contrast, distance has generally been associated with poor outcomes. However, impact of distance on outcomes under the CBA model is unknown. This retrospective cohort study included 537 adults initiated on ART in 2012 in two rural districts in Rwanda. The primary outcomes at 6 months after ART initiation included overall program status, missed a visit and missed three consecutive visits. The associations between cost surface distance (straight-line distance adjusted for surface features) and outcomes were assessed using logistic regression, controlling for potential confounders. Died/lost-to-follow-up and missed three consecutive visits were not associated with distance. Patients within 0-1 km cost surface distance were significantly more likely to miss a visit, potentially due to stigma of attending clinic within one's community. These results suggest that CBA may mediate the impact of long distances on outcomes.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Infecciones por VIH
/
Fármacos Anti-VIH
/
Terapia Antirretroviral Altamente Activa
/
Antirretrovirales
/
Atención Ambulatoria
/
Cumplimiento y Adherencia al Tratamiento
/
Accesibilidad a los Servicios de Salud
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Africa
Idioma:
En
Revista:
AIDS Behav
Asunto de la revista:
CIENCIAS DO COMPORTAMENTO
/
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Año:
2018
Tipo del documento:
Article
País de afiliación:
Ruanda