Larry W. Chang|Stella Alamo|Samuel Guma|Jason B Christopher|Tara Suntoke|Richard Omasete|Jennifer P Montis|Thomas C. Quinn|Margrethe Juncker|Steven J. Reynolds
Two-Year Virologic Outcomes of an Alternative AIDS Care Model: Evaluation of a Peer Health Worker and Nurse-Staffed Community-Based Program in Uganda
Johns Hopkins University|National Institutes of Health
background growing concern human resources needed care increasing numbers patients receiving antiretroviral therapy resourcelimited settings evaluated alternative model communitybased comprehensive antiretroviral program staffed primarily peer health workers nurses methods conducted retrospective cohort study patients receiving antiretroviral therapy first 10 months program enrollment beginning late 2003 virologic immunologic clinical adherence data collected results 360 patients started treatment 258 72 active therapy approximately 2 years later viral load testing demonstrated 86 active patients 211246 tested viral load 400 copies per milliliter median cd4 increase active patients 197 cells per cubic millimeter interquartile range 108346 patients either history antiretroviral use lack cd4 response likely experience virologic failure survival 84 1 year 82 2 years world health organization stage 4 predictive sustaining therapy increased mortality conclusions communitybased antiretroviral treatment program resourcelimited setting provide excellent aids care least 2year period comprehensive program based upon peer health workers nurses provides effective alternative model aids care