Izudi Jonathan, Okot Solomon Paul, Komakech Allan, Bajunirwe Francis
Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda.
African Population and Health Research Center, Nairobi, Kenya.
Am J Trop Med Hyg. 2025 Feb 25;112(5):1048-1051. doi: 10.4269/ajtmh.24-0630. Print 2025 May 7.
We assessed the effect of active follow-ups on viral load (VL) suppression among people living with HIV (PLWH) who had missed their clinic visit(s) and were receiving intensive adherence counseling (IAC) at a large referral hospital in mid-western Uganda. We designed a quasi-experimental study, using a locator map (a local map showing residence) as an external factor (instrumental variable) that influenced active follow-up. We performed instrumental variable analysis. Of the 165 participants included, 24.8% had a client locator map, and possessing a map was associated with active follow-up (F-statistics 53.1; P <0.0001). Active follow-up did not significantly improve VL suppression at varying cutoffs, namely <1,000 copies/ml (P = 0.607), less than 200 copies/ml (P = 0.684), and less than 50 copies/ml (P = 0.435). Although active follow-up did not significantly improve VL suppression among PLWH on IAC, it showed a modest trend toward improvement. Large, randomized trials are needed.
我们评估了主动随访对乌干达中西部一家大型转诊医院中错过门诊就诊且正在接受强化依从性咨询（IAC）的艾滋病毒感染者（PLWH）病毒载量（VL）抑制的影响。我们设计了一项准实验研究，使用定位图（显示居住地的本地地图）作为影响主动随访的外部因素（工具变量）。我们进行了工具变量分析。在纳入的165名参与者中，24.8%有客户定位图，拥有地图与主动随访相关（F统计量53.1；P<0.0001）。在不同的截断值下，即<1000拷贝/毫升（P=0.607）、低于200拷贝/毫升（P=0.684）和低于50拷贝/毫升（P=0.435）时，主动随访并未显著改善VL抑制。虽然主动随访在接受IAC的PLWH中未显著改善VL抑制，但显示出适度的改善趋势。需要进行大规模的随机试验。
