Please use this identifier to cite or link to this item:
Title: Task-Shifting of Antiretroviral Delivery From Health Care Workers to Persons Living With HIV/AIDS: Clinical Outcomes of a Community-Based Program in Kenya
Authors: Kimaiyo Sylvester
Selke Henry
Sidle John
Vedanthan Rajesh
Tierney William M
Shen Changyu
Denski Cheryl
Katschke Adrian
Kara K. Wools-Kaloustian
Keywords: Antiretroviral Therapy
Healthcare Delivery
Health Information Technology
Sub-Saharan Africa
Issue Date: 1-Dec-2010
Publisher: Journal of Acquired Immune Deficiency Syndromes
Abstract: Objectives: To assess whether community-based care delivered by people living with HIV/AIDS (PLWAs) could replace clinic-based HIV care. Design: Prospective cluster randomized controlled clinical trial. Setting: Villages surrounding 1 rural clinic in western Kenya. Subjects: HIV-infected adults clinically stable on antiretroviral therapy (ART). Intervention: The intervention group received monthly Personal Digital Assistant supported home assessments by PLWAs with clinic appointments every 3 months. The control group received standard of care monthly clinic visits. Main Outcomes Measured: Viral load, CD4 count, Karnofsky score, stability of ART regimen, opportunistic infections, pregnancies, and number of clinic visits. Results: After 1 year, there were no significant intervention-control differences with regard to detectable viral load, mean CD4 count, decline in Karnofsky score, change in ART regimen, new opportunistic infection, or pregnancy rate. Intervention patients made half as many clinic visits as did controls (P < 0.001). Conclusions: Community-based care by PLWAs resulted in similar clinical outcomes as usual care but with half the number of clinic visits. This pilot study suggests that task-shifting and mobile technologies can deliver safe and effective community-based care to PLWAs, expediting ART rollout and increasing access to treatment while expanding the capacity of health care institutions in resource-constrained environments.
Appears in Collections:School of Medicine

Files in This Item:
There are no files associated with this item.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.