Perceptions of Community and Clinic-Based Adherence Clubs for Patients Stable on Antiretroviral Treatment: A Mixed Methods Study

Mutsa Mudavanhu, Nora S. West, Sheree R. Schwartz, Lillian Mutunga, Valerie Keyser, Jean Bassett, Annelies Van Rie, Colleen F. Hanrahan

Research output: Contribution to journalArticle

Abstract

Adherence clubs for patients stable on antiretroviral treatment (ART) offer decongestion of clinics and task-shifting, improved adherence and retention in care. Findings on patient acceptability by club location (in the clinic vs. the community) are limited. This was a mixed-methods study set within a randomized controlled trial of community versus clinic-based adherence clubs for retention in care at Witkoppen Health and Welfare Centre in Johannesburg, South Africa. Participants were surveyed on preferences for adherence club-based care (e.g. location, convenience). We conducted in-depth interviews (IDIs) with 36 participants, and surveyed 568 participants: 49% in community-based clubs and 51% in clinic-based clubs. Participants in both arms favorably rated adherence clubs. Almost all (95%) in clinic-based clubs would recommend them to a friend, while fewer (88% in community-based club participants would do so (p = 0.004). Participants found clubs promoted social support, and were convenient and time-saving, though concerns around stigma and access to other health care were noted within community-based clubs. Adherence clubs are a highly acceptable form of differentiated care for stable ART patients. These data indicate that clinic-based clubs may be preferred above community-based clubs, potentially for reasons of stigma and access to additional health care services.

Original languageEnglish (US)
JournalAIDS and behavior
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Patient Compliance
Health Services Accessibility
Therapeutics
South Africa
Social Support
Health Services
Randomized Controlled Trials
Interviews
Delivery of Health Care

Keywords

  • Adherence clubs
  • HIV
  • Mixed methods
  • Retention in care
  • South Africa

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Perceptions of Community and Clinic-Based Adherence Clubs for Patients Stable on Antiretroviral Treatment : A Mixed Methods Study. / Mudavanhu, Mutsa; West, Nora S.; Schwartz, Sheree R.; Mutunga, Lillian; Keyser, Valerie; Bassett, Jean; Van Rie, Annelies; Hanrahan, Colleen F.

In: AIDS and behavior, 01.01.2019.

Research output: Contribution to journalArticle

@article{260a00ff46da4514980fbe03c0c94880,
title = "Perceptions of Community and Clinic-Based Adherence Clubs for Patients Stable on Antiretroviral Treatment: A Mixed Methods Study",
abstract = "Adherence clubs for patients stable on antiretroviral treatment (ART) offer decongestion of clinics and task-shifting, improved adherence and retention in care. Findings on patient acceptability by club location (in the clinic vs. the community) are limited. This was a mixed-methods study set within a randomized controlled trial of community versus clinic-based adherence clubs for retention in care at Witkoppen Health and Welfare Centre in Johannesburg, South Africa. Participants were surveyed on preferences for adherence club-based care (e.g. location, convenience). We conducted in-depth interviews (IDIs) with 36 participants, and surveyed 568 participants: 49{\%} in community-based clubs and 51{\%} in clinic-based clubs. Participants in both arms favorably rated adherence clubs. Almost all (95{\%}) in clinic-based clubs would recommend them to a friend, while fewer (88{\%} in community-based club participants would do so (p = 0.004). Participants found clubs promoted social support, and were convenient and time-saving, though concerns around stigma and access to other health care were noted within community-based clubs. Adherence clubs are a highly acceptable form of differentiated care for stable ART patients. These data indicate that clinic-based clubs may be preferred above community-based clubs, potentially for reasons of stigma and access to additional health care services.",
keywords = "Adherence clubs, HIV, Mixed methods, Retention in care, South Africa",
author = "Mutsa Mudavanhu and West, {Nora S.} and Schwartz, {Sheree R.} and Lillian Mutunga and Valerie Keyser and Jean Bassett and {Van Rie}, Annelies and Hanrahan, {Colleen F.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s10461-019-02681-8",
language = "English (US)",
journal = "AIDS and Behavior",
issn = "1090-7165",
publisher = "Springer New York",

}

TY - JOUR

T1 - Perceptions of Community and Clinic-Based Adherence Clubs for Patients Stable on Antiretroviral Treatment

T2 - A Mixed Methods Study

AU - Mudavanhu, Mutsa

AU - West, Nora S.

AU - Schwartz, Sheree R.

AU - Mutunga, Lillian

AU - Keyser, Valerie

AU - Bassett, Jean

AU - Van Rie, Annelies

AU - Hanrahan, Colleen F.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Adherence clubs for patients stable on antiretroviral treatment (ART) offer decongestion of clinics and task-shifting, improved adherence and retention in care. Findings on patient acceptability by club location (in the clinic vs. the community) are limited. This was a mixed-methods study set within a randomized controlled trial of community versus clinic-based adherence clubs for retention in care at Witkoppen Health and Welfare Centre in Johannesburg, South Africa. Participants were surveyed on preferences for adherence club-based care (e.g. location, convenience). We conducted in-depth interviews (IDIs) with 36 participants, and surveyed 568 participants: 49% in community-based clubs and 51% in clinic-based clubs. Participants in both arms favorably rated adherence clubs. Almost all (95%) in clinic-based clubs would recommend them to a friend, while fewer (88% in community-based club participants would do so (p = 0.004). Participants found clubs promoted social support, and were convenient and time-saving, though concerns around stigma and access to other health care were noted within community-based clubs. Adherence clubs are a highly acceptable form of differentiated care for stable ART patients. These data indicate that clinic-based clubs may be preferred above community-based clubs, potentially for reasons of stigma and access to additional health care services.

AB - Adherence clubs for patients stable on antiretroviral treatment (ART) offer decongestion of clinics and task-shifting, improved adherence and retention in care. Findings on patient acceptability by club location (in the clinic vs. the community) are limited. This was a mixed-methods study set within a randomized controlled trial of community versus clinic-based adherence clubs for retention in care at Witkoppen Health and Welfare Centre in Johannesburg, South Africa. Participants were surveyed on preferences for adherence club-based care (e.g. location, convenience). We conducted in-depth interviews (IDIs) with 36 participants, and surveyed 568 participants: 49% in community-based clubs and 51% in clinic-based clubs. Participants in both arms favorably rated adherence clubs. Almost all (95%) in clinic-based clubs would recommend them to a friend, while fewer (88% in community-based club participants would do so (p = 0.004). Participants found clubs promoted social support, and were convenient and time-saving, though concerns around stigma and access to other health care were noted within community-based clubs. Adherence clubs are a highly acceptable form of differentiated care for stable ART patients. These data indicate that clinic-based clubs may be preferred above community-based clubs, potentially for reasons of stigma and access to additional health care services.

KW - Adherence clubs

KW - HIV

KW - Mixed methods

KW - Retention in care

KW - South Africa

UR - http://www.scopus.com/inward/record.url?scp=85074016402&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074016402&partnerID=8YFLogxK

U2 - 10.1007/s10461-019-02681-8

DO - 10.1007/s10461-019-02681-8

M3 - Article

C2 - 31560093

AN - SCOPUS:85074016402

JO - AIDS and Behavior

JF - AIDS and Behavior

SN - 1090-7165

ER -