短信提醒或同伴家访对喀麦隆感染艾滋病毒青少年坚持抗逆转录病毒治疗及病毒载量抑制的影响：一项随机对照试验。
The impact of short message service reminders or peer home visits on adherence to antiretroviral therapy and viral load suppression among HIV-Infected adolescents in Cameroon: a randomized controlled trial.
作者信息
Ketchaji Alice, Fokam Joseph, Assah Felix, Ateba Francis, Wandji Martial Lantche, Pamen Joelle Nounouce Bouba, Djoko Godfroy Rostant Pokam, Seugnou Cedric Dylan Nana, Kah Emmanuel, Atangana Alain Fouda, Ateudjieu Jerome
机构信息
Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
Virology Laboratory, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management, Yaounde, Cameroon.
出版信息
AIDS Res Ther. 2025 May 1;22(1):49. doi: 10.1186/s12981-025-00746-4.
BACKGROUND
Adherence to antiretroviral therapy (ART) and viral load suppression (VLS) constitute one of the key challenges to control human immunodeficiency virus (HIV), especially during adolescence. This trial aimed at assessing the impact of short message services (SMS) or peer home visits (PHV) on adherence to ART and VL suppression among adolescents living with HIV (ALWHIV) in Cameroon.
METHODS
A randomized controlled trial (RCT) was conducted from July 2018 to February 2019 at the Mother and Child Center of the Chantal Biya Foundation in Yaounde. Eligible ALWHIV (15-19 years), with a fully disclosed HIV status, with availability of phone and guardian's consent, were randomly assigned to receive either daily SMS or bi-weekly PHV for a six-months period. The control-group received standard of care according to the national guidelines. Study investigators and participants were not blinded to the interventions group allocation, and no adverse events or side effects were observed. Adjusted logistic regression was used to assess the impact of interventions on outcomes. The study was approved by The Pan-African Clinical Trials Registry with PACTR201904582515723 at ( www.pactr.org ).
RESULTS
Adherence to ART increased in the PHV (aRR: 4.3; 95% CI: 2.2-8.3; p < 0.001) and SMS (aRR: 3.1, 95% CI: 2.1-5.3; p < 0.001) groups compared to the control-group. Likewise, VL suppression was higher in PHV (aRR: 2.1; 95% CI: 1.9-7.5 p < 0.001) and SMS (aRR: 3.2; 95% CI: 1.8-5.4; p < 0.001) groups compared to the control-group. Based on CI, both interventions showed similar benefits on improving adherence and VLS.
CONCLUSIONS
Among ALHIV, SMS or PHV contribute substantially to improving adherence and VL suppression among ALWHIV. Implementing such strategies would support efforts in eliminating pediatric AIDS in low- and middle-income countries.
背景
坚持抗逆转录病毒疗法（ART）和实现病毒载量抑制（VLS）是控制人类免疫缺陷病毒（HIV）的关键挑战之一，在青少年时期尤为如此。本试验旨在评估短信服务（SMS）或同伴家访（PHV）对喀麦隆感染HIV的青少年（ALWHIV）坚持ART治疗和实现VL抑制的影响。
方法
2018年7月至2019年2月，在雅温得的尚塔尔·比亚基金会母婴中心进行了一项随机对照试验（RCT）。符合条件的ALWHIV（15 - 19岁），HIV感染状况已完全披露，有手机且获得监护人同意，被随机分配接受为期六个月的每日短信服务或每两周一次的同伴家访。对照组按照国家指南接受标准治疗。研究调查人员和参与者对干预组分配情况不设盲，且未观察到不良事件或副作用。采用调整后的逻辑回归评估干预措施对结果的影响。该研究已获得泛非临床试验注册中心批准，注册号为PACTR201904582515723（www.pactr.org）。
结果
与对照组相比，同伴家访组（调整后相对风险：4.3；95%置信区间：2.2 - 8.3；p < 0.001）和短信服务组（调整后相对风险：3.1，95%置信区间：2.1 - 5.3；p < 0.001）的ART治疗依从性均有所提高。同样，与对照组相比，同伴家访组（调整后相对风险：2.1；95%置信区间：1.9 - 7.5；p < 0.001）和短信服务组（调整后相对风险：3.2；95%置信区间：1.8 - 5.4；p < 0.001）的VL抑制率更高。基于置信区间，两种干预措施在提高依从性和实现VL抑制方面显示出相似的益处。
结论
在感染HIV的青少年中，短信服务或同伴家访对提高ALWHIV的治疗依从性和实现VL抑制有显著贡献。实施此类策略将有助于中低收入国家消除儿童艾滋病的努力。
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