Evidence map›Paper›PMID 25276517›Full record

ArticleGlobal health, science and practice2013

Effectiveness of a community-based positive prevention intervention for people living with HIV who are not receiving antiretroviral treatment: a prospective cohort study.

Avina Sarna, Stanley Luchters, Eustasius Musenge, Jerry Okal, Matthew Chersich, Waimar Tun, Sabine Mall, Nzioki Kingola, Sam Kalibala

Open access · diamondAbstract read
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Article in Global health, science and practice, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 5 countries.

Avina SarnaHIV and AIDS Program, Population Council , Delhi , India.
Stanley LuchtersInternational Centre for Reproductive Health, University of Ghent , Belgium ; Faculty of Health Sciences, University of Witwatersrand , Johannesburg, South Africa ; Burnet Institute, Melbourne , Victoria , Australia ; Monash University , Victoria , Australia.
Eustasius MusengeFaculty of Health Sciences, University of Witwatersrand , Johannesburg, South Africa.
Jerry OkalHIV and AIDS Program, Population Council , Nairobi, Kenya.
Matthew ChersichInternational Centre for Reproductive Health, University of Ghent , Belgium ; Faculty of Health Sciences, University of Witwatersrand , Johannesburg, South Africa.
Waimar TunHIV and AIDS Program, Population Council , Washington, DC , USA.
Sabine MallInternational Centre for Reproductive Health , Mombasa, Kenya.
Nzioki KingolaInternational Centre for Reproductive Health , Mombasa, Kenya.
Sam KalibalaHIV and AIDS Program, Population Council , Washington, DC , USA.
Population Council · INInternational Centre for Reproductive Health Kenya · KEInternational Centre for Reproductive Health · MZMonash University · AUUniversity of the Witwatersrand · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe report effectiveness of an HIV-prevention intervention delivered by community health workers (CHWs) in Mombasa, Kenya, to PLHIV who have not initiated or who have discontinued ART-an often difficult-to-reach population because they fall outside the ambit of health care and prevention services.

methodsA 2-arm cohort study assessed a structured risk-reduction intervention involving at least 4 one-to-one counseling sessions and personalized support. The control group received standard prevention services. CHWs recruited treatment-naïve people living with HIV (PLHIV) or those who had previously taken antiretroviral drugs. Data were analyzed using a Propensity Score Matched (PSM)-sample to control for baseline differences between the groups.

results634 PLHIV were recruited and followed for 6 months. Median age was 35 years, and 74.3% were female. Participants in the intervention group reported reduced risky sexual behaviors both at endline compared with baseline and compared with the control group. At endline, in the PSM analysis, participants in the intervention arm were less likely than participants in the control group to report unprotected sex with a spouse (Odds Ratio [OR] = 0.08, 95% confidence interval [CI] = 0.03-0.24), and they reported fewer unprotected sex acts (12.3% versus 46.0%, respectively; OR = 0.16, 95% CI = 0.09-0.29; P<0.001). Further, 92.4% of participants in the intervention group reported zero unsafe sex acts (with partners of negative or unknown HIV status) compared with 70.8% in the control group (P<0.001), and more participants in the intervention arm were receiving ART (34.3% versus 12.7%, respectively; P<0.001).

conclusionCHWs effectively reached PLHIV who had never received or who had discontinued ART, and they delivered a risk-reduction intervention that led to declines in reported sexual risk behaviors, as well as to increases in ART uptake. A scaled-up intervention warrants consideration.

Identifiers

PMID25276517
PMCPMC4168563
OpenAlexW2171080437

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.