Comparison of treatment adherence outcome among PLHIV enrolled in economic strengthening program with community control

ABSTRACT

Economic strengthening (ES) interventions are increasingly promoted to support the economic well-being and food security of people living with HIV (PLHIV) in resource poor settings. This study aims to assess the impact of ES interventions in Ethiopia designed to address poverty and food insecurity on antiretroviral treatment (ART) adherence. A comparative cross-sectional design was employed to compare treatment adherence between food insecure PLHIV benefitting from the ES project of WFP Ethiopia to food insecure PLHIV not participating in ES. Using the visual analogue scale (VAS) to measure ART adherence, only 9.9% of the ES group reported less than 95% adherence compared to 25.9% of the comparison group. Controlling for socio-economic and demographic variables using logistic regression models, engagement in ES activities increased the likelihood of having 95% or greater ART adherence by a factor of 2.4 and 5.6 respectively (as measured by VAS and ACTG approaches) compared to those PLHIV that were not engaged in ES. The findings of the study suggest that engagement in ES contributes to improved ART adherence among food insecure PLHIV. If further studies validate this result, ES should be adopted as a key strategy to improve HIV treatment adherence in resource poor settings where adherence is an issue of concern.

KEYWORDS:

• Economic strengthening
• HIV/AIDS
• treatment adherence
• food security

Acknowledgements

We would like to thank the patients, ART-clinic, and ART-pharmacy staff in all the participating health-care facilities who took part in the study.

Disclosure statement

The author declare that they have no competing interests arisen from the direct applications of this study.

Additional information

Funding

This work was supported by part of the WFP project (urban HIV/AIDS nutrition and food security project) primarily funded by the US-Agency for International Development (USAID) Under [grant number 663-IO-11-00004] and country programme (CP 200253) componenent-4. Dr. Weiser receives salary support from NIH [grant number K24AI134326-01]. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by the funders, Center for Scientific Review.