Antiretroviral Treatment for HIV in Rural Uganda: Two-Year Treatment Outcomes of a Prospective Health Centre/Community-Based and Hospital-Based Cohort
作者： Walter Kipp , Joseph Konde-Lule , L. Duncan Saunders , Arif Alibhai , Stan Houston
DOI: 10.1371/JOURNAL.PONE.0040902
关键词:
摘要: Background: In sub-Saharan Africa a shortage of trained health professionals and limited geographical access to facilities present major barriers the expansion antiretroviral therapy (ART). We tested utility centre (HC)/community-based approach in provision ART persons living with HIV rural area western Uganda. Methods: The treatment outcomes HC/community-based program were evaluated compared those an at best-practice regional hospital. cohort comprised 185 naive patients enrolled 2006. hospital 200 same time period. involved weekly home visits by community volunteers who deliver drugs monitor support adherence identify report adverse reactions other clinical symptoms. Treatment supporters homes also had responsibility remind take their regularly. measured HIV-1 RNA viral load (VL) after two years treatment. Adherence was determined through pill counts. Results: Successful equivalent hospital-based on-treatment analysis (VL=400 copies/mL 93.0% vs. 87.3% p=0.12) intention-to-treat 64.9% 62.0% p = 0.560). multivariate more likely have virologic suppression (adjusted OR 2.47 95% CI 1.01-6.04). Conclusion: Acceptable rates achieved using existing clinic resources run officers supported lay supporters. results primarily doctors.
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