Community-Based Accompaniment and the Impact of Distance for HIV Patients Newly Initiated on Antiretroviral Therapy: Early Outcomes and Clinic Visit Adherence in Rural Rwanda

Fabien Munyaneza*, Joseph Ntaganira, Laetitia Nyirazinyoye, Ermyas Birru, Marie Paul Nisingizwe, Neil Gupta, Cheryl L. Amoroso, Guillaine Neza, Lisa R. Hirschhorn, Bethany L. Hedt-Gauthier

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Community-based accompaniment (CBA) has been associated with improved antiretroviral therapy (ART) patient outcomes in Rwanda. In contrast, distance has generally been associated with poor outcomes. However, impact of distance on outcomes under the CBA model is unknown. This retrospective cohort study included 537 adults initiated on ART in 2012 in two rural districts in Rwanda. The primary outcomes at 6 months after ART initiation included overall program status, missed a visit and missed three consecutive visits. The associations between cost surface distance (straight-line distance adjusted for surface features) and outcomes were assessed using logistic regression, controlling for potential confounders. Died/lost-to-follow-up and missed three consecutive visits were not associated with distance. Patients within 0–1 km cost surface distance were significantly more likely to miss a visit, potentially due to stigma of attending clinic within one’s community. These results suggest that CBA may mediate the impact of long distances on outcomes.

Original languageEnglish (US)
Pages (from-to)77-85
Number of pages9
JournalAIDS and behavior
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2018

Keywords

  • Antiretroviral therapy
  • Cost surface distance
  • Treatment outcomes
  • Visit adherence

ASJC Scopus subject areas

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

Fingerprint Dive into the research topics of 'Community-Based Accompaniment and the Impact of Distance for HIV Patients Newly Initiated on Antiretroviral Therapy: Early Outcomes and Clinic Visit Adherence in Rural Rwanda'. Together they form a unique fingerprint.

Cite this