Did home-based ART participants report more social support after three months?

Details

Home-based antiretroviral therapy (ART) care had expanded in Africa, but the social outcomes of these programs were unknown. In Uganda, researchers assessed the social experiences of participants in an ART program involving weekly home visits. They interviewed participants at enrollment and after three months and analyzed the responses using generalized estimating equations.

Of the 654 participants, 72% were women, and the median baseline CD4 cell count was 123 cells/µL. At follow-up, participants were more likely than at baseline to report community support (adjusted odds ratio [OR] 2.10, 95% confidence interval [CI] 1.46–3.03, P < 0.001), family support (OR 2.65, CI 2.01–3.49, P < 0.001), and strengthened relationships (OR 2.10, CI 1.46–3.03, P = 0.001). Of participants, 84% attributed these experiences to participation in the ART program. There was no change in the incidence of negative experiences (P = 0.3).

Forty-six percent of women reported a history of partner abuse, but reported abuse rates in the three months before and after program initiation were low (1% vs. 2%, OR 3.20, CI 0.94–10.9, P = 0.063). All five women who reported abuse associated with program participation had a history of domestic violence. Among all participants who reported outcomes associated with program participation at follow-up, 464 (79%) reported only positive experiences, 35 (6%) reported both positive and negative experiences, and less than 1% reported only negative experiences.

The researchers concluded that participation in the home-based ART program was associated with multiple positive social outcomes.