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Home-based antiretroviral care is associated with positive social outcomes in a prospective cohort in Uganda


, : Home-based antiretroviral care is associated with positive social outcomes in a prospective cohort in Uganda. JAIDS Journal of Acquired Immune Deficiency Syndromes 44(1): 71-76

Background: Home-based antiretroviral therapy (ART) care in Africa has expanded; but social outcomes of home-based ART programs are unknown.Methods: Social experiences of participants in an antiretroviral therapy program involving weekly home visits in Uganda were assessed through interviews at enrollment and after 3 months and analyzed using generalized estimating equations.Results: Of 654 participants, 72% were women; median baseline CD4 cell-count was 123 cells/mu L. At follow-up, participants were more likely to report community support (adjusted odds ratio [OR] 2.10, 95% confidence interval [CI]: 1.46 to 3.03, P < 0.001), family support (OR 2.65, CI: 2.01 to 3.49, P < 0.001), and relationship strengthening (OR 2.10, Cl: 1.46 to 3.03, P = 0.001) than at baseline; 84% attributed these experiences to antiretroviral therapy program participation. There was no change in incidence of negative experiences (P = 0.3). Forty-six percent of women reported a history of partner abuse, but abuse rates 3 months before and after program initiation were low (1% vs. 2%, OR 3.20, Cl: 0.94 to 10.9, P = 0.063). Of five women who reported abuse associated with program participation, all had history of domestic violence. Of all participants reporting outcomes associated with antiretroviral therapy program participation at follow-up, 464 (79%) had only positive experiences, 35 (6%) had both positive and negative experiences, and < 1% had only negative experiences.Conclusions: Participation in a home-based antiretroviral therapy program was associated with multiple positive social outcomes.

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