Feasibility, challenges, and lessons learned in implementing antiretroviral adherence club models in Northern Tanzania.
Introduction: In Tanzania, nearly 1.6 million adults were living with HIV in 2022, with an HIV prevalence rate of 4.4%. We piloted community health worker-managed adherence clubs in two clinics in Shinyanga, Tanzania. We previously demonstrated better stability in care and improved treatment adheren...
| Publicado en: | African Journal of AIDS Research (AJAR) Vol. 24; no. 3/4; pp. 97 - 107 |
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| Autores principales: | , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Taylor & Francis Ltd
Oct-Dec2025
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=190208254&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 190208254 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 16085906 R93 jtl: African Journal of AIDS Research (AJAR) issn: 16085906 maglogo: N pubinfo: dt: Oct-Dec2025 vid: 24 iid: 3/4 pid: 377 pub: Taylor & Francis Ltd artinfo: ui: 190208254 10.2989/16085906.2025.2577800 ppf: 97 ppct: 10 formats: tig: atl: Feasibility, challenges, and lessons learned in implementing antiretroviral adherence club models in Northern Tanzania. aug: au: Abdul, Ramadhani Duffel, Lukas Van Martelli, Giulia Joel, Edda Ndyamukama Misesemo, Joyce Zacharia Rinke de Wit, Tobias F. Mfinanga, Sayoki Pozniak, Anton Hermans, Sabine affil: Department of Global Health, Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, the Netherlands Department of Global Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands Doctors with Africa Collegio Universitario Aspiranti Medici Missionari (CUAMM), Shinyanga, Tanzania National Institute for Medical Research, Muhimbili Centre, Dar es Salaam, Tanzania Alliance for Africa Health Research, Dar es Salaam, Tanzania Department of HIV, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom Department of Public Health, Kampala International University, Dar Es Salaam, Tanzania Department of Infectious Diseases, Amsterdam Institute for Infection & Immunity, Amsterdam, the Netherlands su: Tanzania Patient compliance Clinical drug trials Antiretroviral agents Pilot projects Scientific observation Logistic regression analysis HIV infections Chi-squared test Descriptive statistics Odds ratio Confidence intervals Medical referrals sug: subj: Patient compliance Tanzania Pharmaceutical and medicine manufacturing Clinical drug trials Antiretroviral agents Pilot projects Scientific observation Logistic regression analysis HIV infections Chi-squared test Descriptive statistics Odds ratio Confidence intervals Medical referrals keyword: adherence clubs ART CHW community health workers HIV adherence clubs ART CHW community health workers HIV ab: Introduction: In Tanzania, nearly 1.6 million adults were living with HIV in 2022, with an HIV prevalence rate of 4.4%. We piloted community health worker-managed adherence clubs in two clinics in Shinyanga, Tanzania. We previously demonstrated better stability in care and improved treatment adherence following the establishment of clubs. This study evaluated referral back to the facility, feasibility, and challenges to inform potential scale-up. Method: The study included clubs from two clinics between July 2018 and September 2019, Ngokolo (13 clubs) and Bugisi (33 clubs), all located in the Shinyanga region. Clinicians invited stable clients to join an AC if they met eligibility criteria. Logistic regression models identified factors associated with the likelihood of clients' referral back to the facilities Results: The setup of the adherence clubs was feasible and successful. In one year, 46 clubs with 617 clients were established. Thirty-eight clients (6.3 %) were referred back to the clinics. Factors associated with being referred back were lower age (below 25 compared to above), having ever missed AC visits, and a rural site. Challenges included start-up problems with wrongful enrolments, the need for additional staff to facilitate the club model, the duplication of data collection tools, and the need for youth-friendly adherence clubs. Conclusion: Task shifting to community health workers to manage the clubs was successful. Despite its success, it required a higher level of organisation, particularly during the setup phase. These findings support the revision of the National HIV guideline to formally integrate community health worker-led adherence clubs, ensuring scalability and sustainability pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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