Effect of Text Messaging Plus Peer Navigation on Viral Suppression Among Youth With HIV in the iCARE Nigeria Pilot Study.

Journal: Journal of acquired immune deficiency syndromes (1999)

Volume: 87

Issue: 4

Year of Publication: 2021

Affiliated Institutions:  Division of Infectious Diseases and Center for Global Health, Northwestern University, Chicago, IL. Infectious Disease Institute, College of Medicine, University of Ibadan, Nigeria. Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL. Department of Child and Adolescent Psychiatry, and Centre for Child and Adolescent Mental Health, College of Medicine, University of Ibadan, Nigeria. Department of Family Medicine, University College Hospital, Ibadan, Nigeria. Department of Medical Social Sciences, Northwestern University, Chicago, IL. Division of Adolescent Medicine, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL. Department of Virology, College of Medicine, University of Ibadan, Nigeria; and. Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.

Abstract summary 

Consistent with the global trend, youth with HIV (YWH) in Nigeria have high rates of viral nonsuppression. Hence, novel interventions are needed.Infectious Diseases Institute, College of Medicine, University of Ibadan, Nigeria.In a single-arm trial, participants aged 15-24 years received 48 weeks of a combination intervention, comprising daily 2-way text message medication reminders plus peer navigation. The primary outcome measure was viral suppression less than 200 copies/mL. The secondary outcome measures included self-reported adherence on a visual analog scale and medication possession ratio, each dichotomized as ≥90% (good) or <90% (poor) adherence. The outcomes were analyzed using McNemar test. Retention in care, intervention feasibility and acceptability, and participants' satisfaction were also assessed.Forty YWH (50% male participants) were enrolled: mean age 19.9 years (SD = 2.5), 55% perinatally infected, and 35% virologically suppressed at baseline. Compared with baseline, the odds of virologic suppression was higher at 24 weeks (odds ratio = 14.00, P < 0.001) and 48 weeks (odds ratio = 6.00, P = 0.013). Self-reported adherence (≥90%) increased from baseline at 24 weeks (63%, P = 0.008) and 48 weeks (68%, P = 0.031). Medication possession ratio ≥90% increased at weeks 24 and 48 (85% and 80%, respectively), achieving statistical significance at 24 weeks alone (P = 0.022). Retention in care at 48 weeks was 87.5%. All (37/37) participants at week 48 were fully or mostly satisfied with the intervention.Daily 2-way text message reminders plus peer navigation is a promising combination intervention to improve viral suppression among YWH in Nigeria.

Authors & Co-authors:  Taiwo Babafemi O BO Kuti Kehinde M KM Kuhns Lisa M LM Omigbodun Olayinka O Awolude Olutosin O Adetunji Adedotun A Berzins Baiba B Janulis Patrick P Johnson Amy K AK Okonkwor Ogochukwu O Oladeji Bibilola D BD Muldoon Abigail A Adewumi Olubusuyi M OM Amoo Paul P Atunde Hannah H Kapogiannis Bill B Garofalo Robert R

Study Outcome 

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Statistics
Citations :  Federal Ministry of Health, Nigeria. National Guidelines for HIV Prevention, Treatment and Care, 2016. Available at: https://www.prepwatch.org/wp-content/uploads/2017/08/nigeria_national_guidelines_2016.pdf.
Authors :  17
Identifiers
Doi : 10.1097/QAI.0000000000002694
SSN : 1944-7884
Study Population
Male
Mesh Terms
Adolescent
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
Niger
Publication Country
United States