FACULTY OF CLINICAL SCIENCES

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Author: search.filters.author.Berzins, B.Subject: search.filters.subject.Adherence

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    Effect of text messaging plus peer navigation on viral suppression among youth with HIV in the iCARE Nigeria pilot study
    (Lippincott Williams & Wilkins (Wolters Kluwer), 2021) Taiwo, B. O.; Kuti, K. M.; Kuhns, L. M.; Omigbodun, O.; Awolude, O.; Adetunji, A.; Berzins, B.; Janulis, P.; Johnson, A. K.; Okonkwor, O.; Oladeji, B. D.; Muldoon, A.; Adewumi, O. M.; Amoo, P.; Atunde, H.; Kapogiannis, B.; Garofalo, R.
    Background—Consistent with the global trend, youth with HIV (YWH) in Nigeria have high rates of viral non-suppression. Novel interventions are needed. Methods—In a single-arm trial, participants aged 15–24 years old received 48 weeks of a combination intervention, comprising daily two-way text message medication reminders plus peer navigation. The primary outcome measure was viral suppression below 200 copies/mL. Secondary outcomes measures included self-reported adherence on a visual analogue scale and medication possession ratio (MPR), each dichotomized as ≥90% (good) or < 90% (poor) adherence. Outcomes were analyzed using McNemar’s test. Retention in care, intervention feasibility and acceptability, and participants’ satisfaction were also assessed. Results—Forty YWH (50% male) were enrolled: mean age 19.9 years (SD=2.5), 55% perinatally-infected, and 35% virologically suppressed at baseline. Compared to baseline, the odds of virologic suppression was higher at 24 weeks (OR = 14.00, p < 0.001) and 48 weeks (OR = 6.00, p = 0.013). Self-reported adherence (≥90%) increased from baseline at 24 weeks (63%, p = 0.008) and 48 weeks (68%, p = 0.031). MPR ≥90% increased at weeks 24 and 48 (85% and 80%, respectively), achieving statistical significance at 24 weeks only (p = 0.022). Retention in care at 48 weeks was 87.5%. All (37/37) participants at week 48 were fully or mostly satisfied with the intervention. Conclusion—Daily, two-way text message reminders plus peer navigation is a promising combination intervention to improve viral suppression among YWH in Nigeria.