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Psychosocial support enhanced treatment retention among adolescents receiving ART

Specialized psychosocial support interventions significantly improved treatment retention among adolescents on antiretroviral treatment, according to study results presented at the 2013 International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur.

According to researchers, HIV-positive adolescents have an increased likelihood of risky behaviors, poor medication adherence and ART failure.

In 2010, a specialized psychosocial support intervention (Teen Club) was established at the Tisungane Clinic at Zomba Central Hospital in Malawi, Africa, which provided teenagers receiving ART with dedicated clinic time, sexual and reproductive health education, as well as peer mentorship and support for positive living and treatment adherence.

To determine the effect of the Teen Club intervention on treatment retention of adolescents on ART, the researchers conducted a cross-sectional analysis of data routinely collected from ART registers and ART master cards in a cohort of adolescents at the Tisungane Clinic.

Patients who attended a Saturday Teen Club between April 1, 2010, and June 1, 2011, were chosen as the exposed group. The researchers assessed a cohort of patients who were aged within 1 year of one another, were the same sex, from a similar location and had an ART start date within 6 months to identify matches among patients who did not participate in Teen Club.

Differences in retention among the groups were evaluated using Kaplan-Meier analysis and Cox proportional hazards regression analyses.

According to study results, 172 Teen Club patients and 134 matched non-Teen Club patients were considered in this study. Among Teen Club patients, 21 (12.2%) were lost to follow-up vs. 83 of the non-Teen Club patients (61.9%).

Adolescents who did not participate in Teen Club exhibited an HR of 5.6 for attrition (95% CI, 3.5-8.9).

“As the pediatric HIV epidemic has evolved with scale up of pediatric ART, interventions addressing retention on treatment for adolescents living with HIV should be a priority in high prevalence, low resource settings,” according to the study abstract. “These results provide evidence that a specialized clinic for adolescents can significantly improve treatment retention among these clients by creating a ‘positive space’ for peer interactions and psychosocial and adherence support. Efforts need to be made to resource these interventions in national programs.”

For more information:

Agarwal M. Abstract MOAD0103. Presented at: 7th IAS Conference on HIV Pathogenesis, Treatment and Prevention; June 30-July 3, 2013; Kuala Lumpur, Malaysia.