An Evaluation of Antiretroviral Therapy Adherence in a Communi ty-Based Multi-Month Dispensing Model in Dodoma City Council
Abstract:
Background: This study evaluates the effects of the community-based multi-month dispensing model on adher ence to antiretroviral therapy among youth living with HIV in Dodoma City Council. It compares adherence rates between three- and six-month dispensing intervals led by either Community Antiretroviral therapy peers or healthcare workers.
Methods: This case-control study used data from the CTC2 database to evaluate the effects of communi ty-based multi-month dispensing of antiretroviral therapy. It compares adherence rates between three- and six-month dispensing intervals led by either community antiretroviral therapy peers and those led by health workers. A total of 390 participants participated in the survey. These participants were categorized into two groups: those enrolled in community-based ART multi-month dispensing (case group) and those not in com munity-based ART multi-month dispensing (control group). Interquartile range were imposed to determine the level of adherence between health facilities, and logistic regression was performed to ascertain the associa tions between communities based muti-months dispensing and adherence and viral suppression.
Results: The study found that community-based multi-month ART dispensing was associated with higher ad herence; those who disliked it also had lower adherence rates. Dispensing intervals and clinical appointment schedules improved adherence. Other factors influenced adherence, including shorter clinic wait times, pref erences, adhering to clinical appointments, and reduced stigma.
Conclusion: Community-based multi-month dispensing of Anti-retroviral therapy significantly improves ad herence among youth living with HIV. Peer-led programs show higher adherence rates, emphasising the im portance of leadership and medication delivery frequency in HIV treatment programs. Addressing logistical obstacles and rationalising medication administration through multi-months can enhance adherence, improve health outcomes, and reduce HIV transmission.
