Nakigozi G., Makumbi F.E., Bwanika J.B., Atuyambe L., Reynolds S.J., Kigozi G., Nalugoda F., Chang L.W., Kiggundu V., Serwadda D., Wawer M.J., Gray R.H., Kamya M.R.
Rakai Health Sciences Program, Kalisizo, Uganda; School of Public Health, Makerere University, College of Health Sciences, Kampala, Uganda; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States; Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, United States; Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda
Nakigozi, G., Rakai Health Sciences Program, Kalisizo, Uganda; Makumbi, F.E., School of Public Health, Makerere University, College of Health Sciences, Kampala, Uganda; Bwanika, J.B., Rakai Health Sciences Program, Kalisizo, Uganda; Atuyambe, L., School of Public Health, Makerere University, College of Health Sciences, Kampala, Uganda; Reynolds, S.J., Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, United States, Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Kigozi, G., Rakai Health Sciences Program, Kalisizo, Uganda; Nalugoda, F., Rakai Health Sciences Program, Kalisizo, Uganda; Chang, L.W., Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Kiggundu, V., Rakai Health Sciences Program, Kalisizo, Uganda; Serwadda, D., School of Public Health, Makerere University, College of Health Sciences, Kampala, Uganda; Wawer, M.J., Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Gray, R.H., Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Kamya, M.R., Department of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda
Background: Data are limited on effects of household or community support persons ("care buddies") on enrollment into and adherence to pre-antiretroviral HIV care. We assessed the impact of care buddies on adherence to HIV clinic appointments, HIV progression, and conduct of daily life among pre-antiretroviral therapy (pre-ART) HIV-infected individuals in Rakai, Uganda. Methods: A total of 1209 HIV-infected pre-ART patients aged ≥15 years were randomized to standard of care (SOC) (n 604) or patient-selected care buddy (PSCB) (n 605) and followed at 6 and 12 months. Outcomes were adherence to clinic visits, HIV disease progression, and self-reported conduct of daily life. Incidence and prevalence rate ratios and 95% confidence intervals (CIs) were used to assess outcomes in the intent-to-treat and as-treated analyses. Results: Baseline characteristics were comparable. In the intent to treat analysis, both arms were comparable with respect to adherence to CD4 monitoring visits [adjusted prevalence risk ratio (adjPRR), 0.98; 95% CI: 0.93 to 1.04; P 0.529], and ART eligibility (adjPRR, 1.00; 95% CI: 0.77 to 1.31; P 0.946). Good conduct of daily life was significantly higher in the PSCB than the SOC arm (adjPRR, 1.08; 95% CI: 1.03 to 1.13; P 0.001). More men (61%) compared with women (30%) selected spouses/partners as buddies (P < 0.0001). Twenty-two percent of PSCB arm participants discontinued use of buddies. Conclusions: In pre-ART persons, having care buddies improved the conduct of daily life of the HIV-infected patients but had no effect on HIV disease progression and only limited effect on clinic appointment adherence. © 2015 Wolters Kluwer Health, Inc.