Impacts of a pilot of community antiretroviral group initiative on HIV-positive patients in a tertiary health facility in Abuja, North Central Nigeria

Abstract

Background: Decentralization, as seen in community antiretroviral group (CAG), has resulted in a significant decline in deaths from AIDS-related causes with projected further benefits in middle- and low-income countries, such as Nigeria. After 2 years of CAG implementation in our facility, this study is designed to assess its impacts on the pilot-cohort of patients, (individual and group), and the hospital facility. Materials and Methods: Pooled data from the CAG register of the pilot cohort of 84 clients, was used for the study. Review of data at entry and 2 years after was done. A questionnaire was used to obtain additional qualitative data. This was administered to all the eighty-four pilot patients and 31 caregivers. Results: There were eight locations, with 84, clients, 62 females and 22 males. The mean/standard deviation of age was 39.38 ± 9.68 years. There were significant increases in weight (kg), (from 65.94 ± 11.012 to 70.69 ± 11.465, P < 0.001), body mass index (kg/m2), (from 24.77 ± 3.879 to 26.79 ± 4.282 P < 0.001), packed cell volume (%) from (31.19 ± 5.014 to 35.64 ± 5.131, P < 0.001), CD4 (cells/mm3), (from 394.36 ± 193.094 to 563.87 ± 220.137 P < 0.001). The viral load suppression was sustained, reducing even further, from 85.06 ± 182.329 to 31.10 ± 46.648 copies/ml, P < 0.001. Retention in care and outcomes were better. Conclusions: From this pilot, the CAG model has shown promise in reducing attrition, improving quality of care, and other direct and indirect benefits, including; cardiovascular, nutritional, and socioeconomic. This has justified the scale-up of this laudable model that will further improve the quality of care given to the patients and the overall quality profile of the facility and system.

Keywords

• abuja
• antiretroviral-care
• decentralization
• pilot