Masquiller 2014.
| Study characteristics | |
| Methods |
Study design: RCT Duration of study: the study was conducted from 2007 to 2010. Country: South Africa Income classification: upper‐middle‐income country from 2007 Geographical scope: urban—five districts in the Free State Province of South Africa (i.e. Lejweleputswa; Motheo; Thabo Mofutsanyana; Fezile Dabi; Xhariep) Healthcare setting: 12 public antiretroviral (ART) clinics across the five districts |
| Participants | 1. Age: 38.9 (SD: 9.5) 2. Gender: both 3. Socioeconomic background: not specified 4. Educational background: most received some secondary education. Inclusion criteria: a. HIV‐positive; b. eligible for public sector ARV treatment (CD4 < 200 and/or WHO stage 4); c. commenced ARV treatment in past 4 weeks; d. patient resident in town/village where ART clinic was located. Exclusion criteria: a. HIV‐negative; b. not eligible for public sector ARV treatment; c. had not commenced ARV treatment; d. commenced ARV treatment longer than 1 month ago; e. patient not resident in town/village where ART clinic was located. Note: considerations on baseline scores not applicable for this study Stated purpose: to analyze the influence of a peer adherence support (PAS) intervention and the family environment on the state of hope in PLWHA |
| Interventions |
Name: PAS Title/name of PW and number: peer adherence supporters (approximately 60) 1. Selection: individuals had to have been on ART therapy for ≥ 12 months and live within walking distance from the relevant clinic. 2. Educational background: at least a grade‐10 certificate 3. Training: peer adherence reporters received 5 days of basic training in ART and adherence support. The training focused on seven main themes: facts about HIV/AIDS, ART, adherence supported needed by an ART client, nutrition, infection control at home, and using a healthcare team approach. On the 5th day of training, peer adherence supporters’ knowledge and practical skills were assessed by the trainers using an oral test and practical exercise. The training was provided by staff at the school. 4. Supervision: supervisors visited each clinic once a month to meet with the relevant peer adherence supporters. During this visit, peer adherence supporters received re‐training on selected topics included in the original main training to refresh and maintain knowledge transfer. In addition, supervisors debriefed PAS, dealt with any logistic problems, and collected completed checklists from PAS. Supervisors completed a standard, short report for each site visit. Following each monthly visit, supervisors met with the PAS co‐ordinator at the Faculty of Medicine, who collated information from their reports and further discussions into a monthly progress report. Information in the monthly report was used to determine PAS payments for the subsequent month. The supervision was delivered by two trained peer adherence support co‐ordinators. 5. Incentives/remuneration: peer adherence supporters were paid a monthly stipend of $100 (ZAR 800), conditional on performance. Prevention type: selective—participants were included based upon the presence of a risk factor (living with HIV/AIDS). Intervention details: the intervention consisted of additional biweekly PAS for a period of 18 months. The peer adherence supporters were people living with HIV/AIDS (PLWHA) who had been on ART for at least 12 months and who had received theoretical and practical training on HIV/AIDS, ART and adherence, nutrition and infection control in the home, based on material developed by the UFS’s School of Nursing. When visiting patients, peer adherence supporters provided support with adherence and discussed matters that can make adherence more difficult (e.g. stigma). They identified possible side effects of ART and acted appropriately. When necessary, they referred patients to a clinic. Other topics (e.g. unemployment or pension grants) were discussed as well. Control: usual care – antiretroviral therapy (ART) |
| Outcomes |
Participants’outcomes of interest for this review
Carers’ outcomes of interest for this review Nil Economic outcomes Nil Time points: baseline, post‐intervention (1‐6 months; 7‐24 months) Note: data were not included in the meta‐analysis because they were not provided in the right format or were not available even after attempted author contact. |
| Notes |
Source of funding: we are particularly grateful to the following funding agencies: The Research Committee of the World Bank, the Bank‐Netherlands Program Partnership, WB‐DfID Evaluation of the Community Response to HIV and AIDS, the Programme to Support Pro‐Poor Policy Development (PSPPD; a partnership between the Presidency, Republic of South Africa and the European Union), the Health Economics and Aids Research Division (HEARD) at the University of
Kwazulu‐Natal, the University of the Free State (UFS), and South Africa’s National Research Foundation (NRF). Notes on validation of instruments (screening and outcomes): HADS scales are widely validated and established. Additional information: none Handling the data: not available Prospective trial registration number: DOH‐27‐ 0907‐2025; NCT00821366 |