Behavioral and Policy Sciences Department, RAND Corporation, Santa Monica, CA, USA.
Department of Health Promotion and Policy, University of Massachusetts Amherst, 715 N. Pleasant St., Amherst, MA, 01003, USA.
AIDS Behav. 2023 Mar;27(3):864-874. doi: 10.1007/s10461-022-03821-3. Epub 2022 Sep 6.
A pilot cluster randomized controlled trial involving two HIV clinics in the Dominican Republic assessed preliminary efficacy of an urban garden and peer nutritional counseling intervention. A total of 115 participants (52 intervention, 63 control) with moderate or severe food insecurity and sub-optimal antiretroviral therapy (ART) adherence and/or detectable viral load were assessed at baseline, 6- and 12-months. Longitudinal multivariate regression analysis controlling for socio-demographics and accounting for serial cluster correlation found that the intervention: reduced the prevalence of detectable viral load by 20 percentage points at 12 months; reduced any missed clinic appointments by 34 and 16 percentage points at 6 and 12 months; increased the probability of "perfect" ART adherence by 24 and 20 percentage points at 6 and 12 months; and decreased food insecurity at 6 and 12 months. Results are promising and warrant a larger controlled trial to establish intervention efficacy for improving HIV clinical outcomes.Trial registry Clinical Trials Identifier: NCT03568682.
一项涉及多米尼加共和国两家 HIV 诊所的试点集群随机对照试验评估了城市花园和同伴营养咨询干预措施的初步效果。共有 115 名参与者（52 名干预组，63 名对照组）存在中度或重度粮食不安全和抗逆转录病毒疗法（ART）依从性差或可检测到病毒载量的情况，在基线、6 个月和 12 个月时进行了评估。纵向多变量回归分析控制了社会人口统计学因素，并考虑了连续聚类相关性，结果发现该干预措施：在 12 个月时将可检测到的病毒载量的流行率降低了 20 个百分点；在 6 个月和 12 个月时分别将错过诊所预约的比例降低了 34 和 16 个百分点；在 6 个月和 12 个月时将“完美”ART 依从率的可能性分别提高了 24 和 20 个百分点；在 6 个月和 12 个月时降低了粮食不安全的情况。结果令人鼓舞，需要进行更大规模的对照试验来确定改善 HIV 临床结果的干预措施的疗效。试验注册临床试验标识符：NCT03568682。
