The Treatment Ambassador Program: A Highly Acceptable and Feasible Community-Based Peer Intervention for South Africans Living with HIV Who Delay or Discontinue Antiretroviral Therapy

Ingrid T. Katz, Laura M. Bogart, Garrett M. Fitzmaurice, Vincent S. Staggs, Marya V. Gwadz, Ingrid V. Bassett, Anna Cross, Ingrid Courtney, Lungiswa Tsolekile, Regina Panda, Sonja Steck, David R. Bangsberg, Catherine Orrell, Kathy Goggin

Research output: Contribution to journalArticlepeer-review

Abstract

We conducted a novel pilot randomized controlled trial of the Treatment Ambassador Program (TAP), an 8-session, peer-based, behavioral intervention for people with HIV (PWH) in South Africa not on antiretroviral therapy (ART). PWH (43 intervention, 41 controls) completed baseline, 3- and 6-month assessments. TAP was highly feasible (90% completion), with peer counselors demonstrating good intervention fidelity. Post-intervention interviews showed high acceptability of TAP and counselors, who supported autonomy, assisted with clinical navigation, and provided psychosocial support. Intention-to-treat analyses indicated increased ART initiation by 3 months in the intervention vs. control arm (12.2% [5/41] vs. 2.3% [1/43], Fisher exact p-value = 0.105; Cohen’s h = 0.41). Among those previously on ART (off for > 6 months), 33.3% initiated ART by 3 months in the intervention vs. 14.3% in the control arm (Cohen’s h = 0.45). Results suggest that TAP was highly acceptable and feasible among PWH not on ART.

Original languageEnglish (US)
JournalAIDS and Behavior
DOIs
StateAccepted/In press - 2020

Keywords

  • ART initiation
  • Behavioral intervention
  • Differentiated service delivery
  • Engagement in care
  • Motivational interviewing
  • Peer-based intervention
  • South Africa

ASJC Scopus subject areas

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

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