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AIDS and Behavior
Published in: AIDS and Behavior 1/2018

01-01-2018 | Original Paper

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

Authors: 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

Published in: AIDS and Behavior | Issue 1/2018

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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.
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Metadata
Title
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
Authors
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
Publication date
01-01-2018
Publisher
Springer US
Published in
AIDS and Behavior / Issue 1/2018
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-016-1658-5

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