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Presenter Kibaara Charles K.

Evaluating the association of Treatment buddy( TBy ) to ART appointment adherence and retention in Kisumu. Kibaara C. 1,2 , Blat, C. 2,3 , Lewis-kulzer, J K. 2,3 , Mbullo P. 1,2 , Bukusi EA. 1,2 , Cohen CR. 2,3. Presenter Kibaara Charles K.

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Presenter Kibaara Charles K.

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  1. Evaluating the association of Treatment buddy(TBy) to ART appointment adherence and retention in Kisumu Kibaara C.1,2, Blat, C.2,3, Lewis-kulzer, J K.2,3 , Mbullo P.1,2, Bukusi EA.1,2, Cohen CR.2,3 Presenter Kibaara Charles K. January 2013University of Nairobi Annual Collaborative Meeting

  2. Introduction • Treatment Buddy(Tby)(i.e. a friend or family member, known to the clinic, helping the patient taking ART) is not requested but patients are advised to have one-Sometimes referred at treatment supporter

  3. Background • HIV-infected patients on antiretroviral therapy (ART) who miss clinic appointments risk: • Drug interruptions • Poorer health outcomes • Drug resistance • Kenyan ART Guidelines encourage a Treatment Buddy (Tby) to maximize patient adherence

  4. Study Objectives • To examine if having a TBy reduces the risk of missed appointment or loss to follow-up (LTFU) within first year on ART • We defined Missed appointment as missing clinic appointment day by more than 3 days after ones “clinic return date” • LTFU defined as any person whose last TCA was scheduled > 90 days before the date the file is reviewed, and who has not come to the clinic for care, AND is NOT dead, transfer out, declined care *Excluding those who discontinued

  5. Methods Sample • Retrospective cohort study • Four Family AIDS Care and Education Services (FACES) supported health facilities in Kisumu, Kenya • HIV-infected adults >15 years of age • Initiated ART between August 1, 2007 and March 27, 2011 • Patient demographics, clinic attendance, and Tby status at ART initiation abstracted from electronic medical records

  6. Methods cont’d Analysis • Bivariate logistic regression to assess whether patients with a TBy had lower odds of missed appointment or LTFU • Breslow-Day test to assess whether effects of Tby on appointment adherence and LTFU differed by gender • Odds ratios (OR) and 95% confidence intervals (CI) reported

  7. Results (Variables) • Comparing patients with Treatment Buddy • Among a cohort of 2,074 patients, 1,390 (67%) were female and 684 (33%) were male • Among the patients with Tbys were 1,211(87.1%) females and 645 (94.3%) males

  8. Results Comparing patients with Treatment Buddy • Patients with a Tby were older(mean age=33.8 vs. 31.2 years; OR=1.03 per year increase in age, 95% CI=1.02-1.05) • more likely to be married/partnered (58% vs. 38%; OR=2.07, 95% CI=1.49-2.89) compared to those without a TBy.

  9. Results

  10. Results *Excludes discontinued within first year on ART.

  11. Conclusion • Tbys may be more strongly associated with appointment adherence in females than males. • TBys were not associated with better first-year retention. • Further research is needed to elucidate the effects of TByon adherence, retention and clinical outcomes in patients on ART.

  12. Acknowledgements • PERFAR/CDC • MOH • FACES • UCSF • KEMRI

  13. Questions

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