The Treatment Ambassador Program: A Highly Acceptable and Feasible Community-Based Peer Intervention for South Africans Living with HIV Who Delay or Discontinue Antiretroviral Therapy
Ingrid T Katz, Laura M Bogart, Garrett M Fitzmaurice, Vincent S Staggs, Marya V Gwadz, Ingrid V Bassett, Anna Cross, Ingrid Courtney, Lungiswa Tsolekile, Regina Panda, Sonja Steck, David R Bangsberg, Catherine Orrell, Kathy Goggin, Ingrid T Katz, Laura M Bogart, Garrett M Fitzmaurice, Vincent S Staggs, Marya V Gwadz, Ingrid V Bassett, Anna Cross, Ingrid Courtney, Lungiswa Tsolekile, Regina Panda, Sonja Steck, David R Bangsberg, Catherine Orrell, Kathy Goggin
Abstract
We conducted a novel pilot randomized controlled trial of the Treatment Ambassador Program (TAP), an 8-session, peer-based, behavioral intervention for people with HIV (PWH) in South Africa not on antiretroviral therapy (ART). PWH (43 intervention, 41 controls) completed baseline, 3- and 6-month assessments. TAP was highly feasible (90% completion), with peer counselors demonstrating good intervention fidelity. Post-intervention interviews showed high acceptability of TAP and counselors, who supported autonomy, assisted with clinical navigation, and provided psychosocial support. Intention-to-treat analyses indicated increased ART initiation by 3 months in the intervention vs. control arm (12.2% [5/41] vs. 2.3% [1/43], Fisher exact p-value = 0.105; Cohen's h = 0.41). Among those previously on ART (off for > 6 months), 33.3% initiated ART by 3 months in the intervention vs. 14.3% in the control arm (Cohen's h = 0.45). Results suggest that TAP was highly acceptable and feasible among PWH not on ART.
Keywords: ART initiation; Behavioral intervention; Differentiated service delivery; Engagement in care; Motivational interviewing; Peer-based intervention; South Africa.
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Source: PubMed