A community-based peer-facilitated psychological and social support model to improve retention in care among Cameroonian adolescents perinatally infected with human immunodeficiency virus: A randomized controlled trial.

Journal: Journal of epidemiology and population health

Volume: 72

Issue: 6

Year of Publication: 

Affiliated Institutions:  Faculty of Medicine and Biomedical Sciences, University of Garoua, Cameroon; Centre Mère-enfant, Fondation Chantal Biya, Yaounde, Cameroon; Ministry of Public Health, Yaounde, Cameroun. Electronic address: atebfranc@gmail.com. Media Convergence Consulting Office, Yaounde, Cameroon. Ministry of Public Health, Yaounde, Cameroun. University of Douala, Douala, Cameroon. KidAIDS Cameroon, Yaounde, Cameroon. Centre Pasteur du Cameroun, Yaounde, Cameroun. Centre Mère-enfant, Fondation Chantal Biya, Yaounde, Cameroon. Centre Hospitalier Universitaire Gabriel Touré, Bamako, Mali. Centre International de Recherche Chantal Biya, Yaounde, Cameroun. Research Institute for Sustainable Development (IRD), Abidjan, Côte d'Ivoire. General Paediatrics Department, Hôpital Universitaire Robert Debré, Paris, France. Programs for HIV Prevention and Treatment (PHPT) Foundation - Research Institute for Sustainable Development (IRD), Paris, France. Ministry of Public Health, Yaounde, Cameroun; Faculty of Medicine and Biomedical Sciences, University of Yaounde , Yaounde, Cameroon.

Abstract summary 

Psychological and social support for adolescents living with HIV remains undocumented and unaddressed in Central Africa. This study aimed at assessing effectiveness of a peer-facilitated community-based support model in improving retention in care among adolescents living with HIV and attending care in Chantal Biya Foundation, Yaounde, Cameroon.We conducted an analysis of adolescents aged 10-19 years old, perinatally infected with HIV, on follow-up in the Day Care Unit of a reference hospital in Yaounde, Cameroon, and enrolled in the IAS-CIPHER-2021/1214-ATE-SMAVI, a individually randomized controlled trial. While the control arm only received routine care in the health facility, the intervention arm, in addition, was assigned to an HIV association for sustained support model, including support groups, leisure workshops and home visits. Structured questionnaires, including validated French versions of mental health scales, were quarterly administered to the study participants in both study arms by trained healthcare providers. The main outcome was maintaining retention in care beyond the first 15-month period of the study start. Kaplan-Meier and Cox regression models were fitted to assess association between intervention and outcome. Hazard Ratio (HR) across categories of exposure variables were compared using Wald's test. p-value <0.05 was considered significant.In total, 305 adolescents were recruited in the study at a median age of 15.2 years old, including 162 (53.1 %) females and 153 individuals in the intervention arm. Mental health troubles were prevalent: severe depression (26.9 %), high or very high anxiety (28.9 %), and low self-esteem (84.9 %). Noteworthy, all of the baseline characteristics were balanced irrelevant to the study arm. Probability of maintaining good retention in care beyond the first 15-month period of study start remained higher in the intervention arm (82.0 % [95 %CI: 73.7 %-88.4 %]) versus the control arm (71.0 % [95 %CI: 63.2 %-78.1 %]), [cHR (95 %CI): 2.0 (1.1-3.3), p=0.044].Capacity should be built in terms of implementing community-based peer-facilitated support groups in local organizations providing care to adolescents living with HIV.

Authors & Co-authors:  Ndongo Francis Ateba FA Noah Jean-Pierre Yves Awono JYA Kana Rogacien R Ndie Justin J Nono MariusTchassep M Ndzie Patrice P Tejiokem Mathurin Cyrille MC Biheng Emmanuelle Hopp EH Nkoa Tatiana Avang TA Coulibaly Yacouba Aba YA Fokam Joseph J Ketchaji Alice A Ngako Joëlle Nounouce JN Penda Calixte Ida CI Ndombo Paul Olivier Koki POK Hawa Hubert Mbassi HM Msellati Philippe P Faye Albert A Lallemant Marc M Bissek Anne Cécile Zoung-Kani ACZ

Study Outcome 

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Statistics
Citations : 
Authors :  20
Identifiers
Doi : 10.1016/j.jeph.2024.202792
SSN : 2950-4333
Study Population
Females
Mesh Terms
Other Terms
Adolescents perinatally infected with HIV;Community-based psychological and social support;Peer-facilitation;Retention in care
Study Design
Randomized Control Trial
Study Approach
Country of Study
Cameroon
Publication Country
France