Adherence Support Workers: A Way to Address Human Resource Constraints in Antiretroviral Treatment Programs in the Public Health Setting in Zambia
2008

Adherence Support Workers in Zambia's Antiretroviral Treatment Programs

Sample size: 500 publication 10 minutes Evidence: moderate

Author Information

Author(s): Torpey Kwasi E., Kabaso Mushota E., Mutale Liya N., Kamanga Mpuma K., Mwango Albert J., Simpungwe James, Suzuki Chiho, Mukadi Ya Diul

Primary Institution: Family Health International/Zambia Prevention Care and Treatment Partnership

Hypothesis

Can training community volunteers as adherence support workers improve adherence counseling and treatment retention in Zambia's antiretroviral therapy programs?

Conclusion

The study found that adherence counseling tasks can be effectively shifted to lay workers without compromising quality, leading to improved patient retention and reduced loss to follow-up rates.

Supporting Evidence

  • Loss to follow-up rates of new clients declined from 15% to 0% after the deployment of ASWs.
  • Quality of adherence counseling by ASWs was comparable to HCWs after their introduction.
  • ASWs helped reduce waiting times for adherence counseling.

Takeaway

This study shows that training community members to help people take their HIV medicine can make it easier for patients to get the support they need and stay healthy.

Methodology

The study used quantitative and qualitative methods, including structured interviews with 500 ART patients and analysis of electronic patient records before and after the introduction of adherence support workers.

Potential Biases

Potential selection bias due to interviewing clients who were retained in care.

Limitations

The study was limited to five ART sites and relied on self-reported adherence, which may introduce bias.

Participant Demographics

The sample included 295 females (59.0%) and 205 males (41.0%), mostly aged 35-49 years.

Statistical Information

P-Value

p<0.05

Confidence Interval

95% Confidence Interval: −0.64; 0.04

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pone.0002204

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