ArticleSouthern African journal of HIV medicine2019
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Article in Southern African journal of HIV medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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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.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Exploring Sustainability in the Era of Differentiated HIV Service Delivery in Sub-Saharan Africa: A Systematic Review.Journal of acquired immune deficiency syndromes (1999) · 2021Pooled it
- How Government Policies and Organisational and Sectoral Circumstances Influence Nurse Practitioner and Physician Assistant Employment and Training: A Realist Analysis Using Surveys.Journal of advanced nursing · 2026Article
- Developing community-based programme theories to address unmet needs of people experiencing homelessness and severe mental illness: protocol for a realist review.NIHR open research · 2026Article
- Experiences of Older People Living with Human Immunodeficiency Virus Comorbidity Attending Coordinated Healthcare Services.Annals of geriatric medicine and research · 2025Article
- Barriers and facilitators to the implementation and scale up of differentiated service delivery models for HIV treatment in Africa: a scoping review.BMC health services research · 2022Article
- Patient-centred care: reality or rhetoric-patients' experiences at ARV clinics located in public hospitals in KwaZulu-Natal, South Africa.AIDS research and therapy · 2022Article
- Using Intervention Mapping methodology to design an HIV linkage intervention in a refugee settlement in rural Uganda.AIDS care · 2022Article
- Article
- Implementing 'universal' access to antiretroviral treatment in South Africa: a scoping review on research priorities.Health policy and planning · 2021Article
- Community Group-Based Models of Medication Delivery: Applicability to Cardiovascular Diseases.Global heart · 2021Review
- Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: a realist synthesis.BMC pregnancy and childbirth · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAn estimated 7.9 million people were living with HIV in South Africa in 2017, with 63.3% of them remaining in antiretroviral therapy (ART) care and 62.9% accessing ART. Poor retention in care and suboptimal adherence to ART undermine the successful efforts of initiating people living with HIV on ART. To address these challenges, the antiretroviral adherence club intervention was designed to streamline ART services to 'stable' patients. Nevertheless, it is poorly understood exactly how and why and under what health system conditions the adherence club intervention works.
objectivesThe aim of this study was to test a theory on how and why the adherence club intervention works and in what health system context(s) in a primary healthcare facility in the Western Cape Province.
methodWithin the realist evaluation framework, we applied a confirmatory theory-testing case study approach. Kaplan-Meier descriptions were used to estimate the rates of dropout from the adherence club intervention and virological failure as the principal outcomes of the adherence club intervention. Qualitative interviews and non-participant observations were used to explore the context and identify the mechanisms that perpetuate the observed outcomes or behaviours of the actors. Following the retroduction logic of making inferences, we configured information obtained from quantitative and qualitative approaches using the intervention-context-actor-mechanism-outcome heuristic tool to formulate generative theories.
resultsWe confirmed that patients on ART in adherence clubs will continue to adhere to their medication and remain in care because their self-efficacy is improved; they are motivated or are being nudged.
conclusionA theory-based understanding provides valuable lessons towards the adaptive implementation of the adherence club intervention.
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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.