南非快递艾滋病毒治疗交付和短信支持干预措施在艾滋病毒感染者年轻人中接受度、可行性和初步效果。

The Acceptability, Feasibility, and Preliminary Effectiveness of a Courier HIV-Treatment Delivery and SMS Support Intervention for Young People Living With HIV in South Africa.

机构信息

Department of Epidemiology, Emory University, Atlanta, GA.

Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC; and.

出版信息

J Acquir Immune Defic Syndr. 2024 Feb 1;95(2):161-169. doi: 10.1097/QAI.0000000000003332.

DOI:10.1097/QAI.0000000000003332

PMID:37856424

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10841708/

Abstract

BACKGROUND

Young people living with HIV (YPLWH) experience poorer rates of virological suppression compared with adults. Differentiated service delivery models for YPLWH are urgently needed to address this disparity.

SETTING

Participants were recruited from an HIV treatment clinic near Cape Town, South Africa.

METHODS

We conducted a longitudinal pilot study to examine the acceptability, feasibility, and preliminary effectiveness of a courier ART delivery and SMS support intervention to retain YPLWH (13-24 years) in care during COVID-19. YPLWH had the option to enroll in the courier service and were randomized 1:1 to receive adherence support via a weekly SMS. Modified Poisson regression was used to estimate the preliminary effectiveness of the courier intervention on viral suppression (HIV-1 RNA <200 copies/mL) at months 3 and 6.

RESULTS

Among 215 participants, 82% elected to enroll in the courier ART service at baseline, 41% reported receiving a delivery in the past 3 months at month 3, and 49% reported receiving a delivery in the past 3 months at month 6. Among those who received a delivery, most (91%-100%) rated the intervention as acceptable. Participants who reported receiving a delivery in the past 3 months at month 3 were 1.26 (95% CI: 1.05, 1.54) times as likely to have a suppressed viral load at month 3 and 1.21 (0.99, 1.48) times as likely at month 6, controlling for potential confounders.

CONCLUSIONS

Findings reveal high uptake and acceptability of a courier ART delivery intervention among YPLWH and promising evidence for its effectiveness in increasing the probability of viral suppression. A fully powered trial is warranted.

摘要

背景

与成年人相比，感染艾滋病毒的年轻人（YPLWH）的病毒学抑制率较低。迫切需要为 YPLWH 提供差异化的服务交付模式，以解决这一差距。

地点

参与者是从南非开普敦附近的一家艾滋病毒治疗诊所招募的。

方法

我们进行了一项纵向试点研究，以检查快递 ART 交付和短信支持干预措施的可接受性、可行性和初步效果，以在 COVID-19 期间留住 YPLWH（13-24 岁）接受护理。YPLWH 可以选择参加快递服务，并被随机分为 1:1 组，通过每周短信接受依从性支持。修正泊松回归用于估计快递干预措施在第 3 个月和第 6 个月对病毒抑制（HIV-1 RNA <200 拷贝/毫升）的初步效果。

结果

在 215 名参与者中，82%的人在基线时选择参加快递 ART 服务，41%的人在第 3 个月报告在过去 3 个月内收到过一次交付，49%的人在第 6 个月报告在过去 3 个月内收到过一次交付。在收到交付的人中，大多数（91%-100%）对干预措施的评价是可以接受的。在第 3 个月报告在过去 3 个月内收到过一次交付的参与者，在第 3 个月时病毒载量得到抑制的可能性是 1.26 倍（95%CI：1.05，1.54），在第 6 个月时是 1.21 倍（0.99，1.48），控制了潜在的混杂因素。