Evidence map›Paper›PMID 41214254›Full record

Trial reportAIDS and behavior2026

Self-Efficacy and One-Year HIV Outcomes for Hospitalized People with HIV in Tanzania: A Mediation Analysis of the Daraja Clinical Trial.

Philip Ayieko, Megan Willkens, Benson Issarow, Derick Deogratias, Daniel W Fitzgerald, Heiner Grosskurth, Godfrey Kisigo, Elialilia Okello, Lisa R Metsch, Robert N Peck and 2 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in AIDS and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03858998 (Reducing Post-Hospital Mortality in HIV-infected Adults in Tanzania), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

NCT03858998 nacompletednot on this map

Reducing Post-Hospital Mortality in HIV-infected Adults in Tanzania

TypeinterventionalSponsorWeill Medical College of Cornell UniversityRan2019 to 2024Enrolled500ConditionsHIV InfectionsArmsCase Management Intervention, Control
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Philip AyiekoMwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.
Megan WillkensCenter for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
Benson IssarowMwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.
Derick DeogratiasMwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.
Daniel W FitzgeraldCenter for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
Heiner GrosskurthMwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.
Godfrey KisigoMwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.
Elialilia OkelloMwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.
Lisa R MetschDepartment of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
Robert N PeckMwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.
Saidi KapigaMwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.
Myung Hee LeeCenter for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, USA. myl2003@med.cornell.edu.

Funding

Reducing Post-Hospital Mortality in HIV-Infected Adults in TanzaniaR01MH118107 · NIMH · WEILL MEDICAL COLL OF CORNELL UNIV · PI PECK, ROBERT N · 2018 to 2022
$2.7M
Post-Doctoral Fellowship Training in HIV Clinical InvestigationD43TW011826 · FIC · WEILL MEDICAL COLL OF CORNELL UNIV · PI Daniel W Fitzgerald, Saidi Kapiga · 2021 to 2026
$1.9M
Patient-Oriented Research in Global Cardiovascular Diseases and Interactions with HIVK24HL170902 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI Robert N Peck · 2023 to 2026
$504k
FIC NIH HHS D43 TW 011826FIC NIH HHS D43 TW011826NHLBI NIH HHS K24 HL 170902NHLBI NIH HHS K24 HL170902NIMH NIH HHS R01 MH 118107NIMH NIH HHS R01 MH118107
6 · The paper itself

Abstract

Examining the causal pathways through which the Daraja intervention led to sustained improvement in HIV outcomes, including retention in HIV care, ART adherence, and viral load suppression, could highlight critical mechanisms for improving post-hospital outcomes in people with HIV. This pre-specified analysis of the Daraja trial assessed five mediators identified from the Gelberg-Andersen model (self-efficacy, social support, perceived need for HIV services, perceived stigma, and traditional HIV beliefs) and two additional potential mediators, depression and alcohol use. Mediators were quantified pre- and post-intervention. A causal mediation analysis framework was used to construct independent single mediator models for each hypothesized mediator to understand their effect on HIV-related outcomes. Our intervention-mediator analysis demonstrated that the Daraja intervention improved self-efficacy (1.34 (95% CI (0.2, 2.48)) but no effect on other factors in the Gelberg-Andersen model. In our mediator-outcome analysis, improvements in self-efficacy, social support, and traditional HIV beliefs were associated with higher retention in care at 12 months. Results were similar for other HIV outcomes. Self-efficacy was associated with all three HIV outcomes, according to the intervention-mediator effect, mediator-outcome effect, average causal mediation effect, and average total effect. For these outcomes, 37-42% of the intervention effect was mediated by self-efficacy. Self-efficacy was an important mediator of the effect of the Daraja intervention in promoting retention in HIV care, improving ART adherence and reducing HIV viral load. Targeting self-efficacy appears to be critical for enabling hospitalized people with HIV to make the difficult transition from hospital to primary HIV care and live a healthy life with HIV.Clinical Trial Number ClinicalTrials.gov Identifier NCT03858998.

Indexed as

Anti-HIV AgentsHIV InfectionsMedication AdherenceSelf EfficacyAdultDepressionFemaleHospitalizationHumansMaleMediation AnalysisMiddle AgedRetention in CareSocial StigmaSocial SupportTanzaniaAnti-HIV AgentsHospitalized people with HIVLinkage case management: TanzaniaSelf-efficacy

Identifiers

PMID41214254
PMCPMC12771576

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Registered trials

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.