A Retrospective Cohort Study comparing Retention and Viral suppression between Co-morbidity Adherence Clubs and HIV-Only Adherence Clubs in Cape Town, South Africa
type: CreativeWork
description: In South Africa, there is an increasing population of those with both Human Immunodeficiency Virus (HIV) and one or more non-communicable diseases (NCDs). This is thought to be due to a number of factors, including both the successful Antiretroviral Therapy (ART) programme (which has increased the life-expectancy of those with HIV) and the increasing prevalence of NCDs (due to an aging population, lifestyle changes and urbanisation). This co-morbid population has been shown have poor health outcomes especially in terms of adherence (due to pill burden, multiple appointments etc). There are currently very few models of integrated care for those with both HIV and NCDs, despite well-documented potential benefits of this approach for both the patient and the health system (in terms of efficiency). One such model of care, the co-morbidity adherence clubs (for those with both HIV and hypertension and/or diabetes), was implemented in 2016 in South Africa and this study aims to compare the key outcomes of retention and viral suppression between these clubs and the established HIV-only adherence clubs. Part A is the study protocol which lays the foundation for the need for this research, and explains how the research will be conducted. Part B forms the literature review which gives a summary of the existing literature and provides context for the dissertation. Part C is the manuscript, presenting the analysis of the retrospective cohort study, and includes a discussion on the implications of key findings. The study sample comprised 602 HIV-positive adults (501 from the HIV-only club model and 101 from the co-morbidity club model). The overall female proportion was 70.3% and the median age was 38 years. The results showed that there was no difference in the proportion of those retained (84.2% vs 85.6%, p=0.703) or the proportion who were virally suppressed (97% vs 97%, p=0.999) in the co-morbidity club compared to the HIV-only club. In multivariable logistic regression models…
abstract: In South Africa, there is an increasing population of those with both Human Immunodeficiency Virus (HIV) and one or more non-communicable diseases (NCDs). This is thought to be due to a number of factors, including both the successful Antiretroviral Therapy (ART) programme (which has increased the life-expectancy of those with HIV) and the increasing prevalence of NCDs (due to an aging population, lifestyle changes and urbanisation). This co-morbid population has been shown have poor health outcomes especially in terms of adherence (due to pill burden, multiple appointments etc). There are currently very few models of integrated care for those with both HIV and NCDs, despite well-documented potential benefits of this approach for both the patient and the health system (in terms of efficiency). One such model of care, the co-morbidity adherence clubs (for those with both HIV and hypertension and/or diabetes), was implemented in 2016 in South Africa and this study aims to compare the key outcomes of retention and viral suppression between these clubs and the established HIV-only adherence clubs. Part A is the study protocol which lays the foundation for the need for this research, and explains how the research will be conducted. Part B forms the literature review which gives a summary of the existing literature and provides context for the dissertation. Part C is the manuscript, presenting the analysis of the retrospective cohort study, and includes a discussion on the implications of key findings. The study sample comprised 602 HIV-positive adults (501 from the HIV-only club model and 101 from the co-morbidity club model). The overall female proportion was 70.3% and the median age was 38 years. The results showed that there was no difference in the proportion of those retained (84.2% vs 85.6%, p=0.703) or the proportion who were virally suppressed (97% vs 97%, p=0.999) in the co-morbidity club compared to the HIV-only club. In multivariable logistic regression models…
author: Allerton, Joanna
date published: 2018
date modified: 2026-07-22T22:23:38Z
provider: University of Cape Town
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Department of Public Health and Family Medicine

PropertyValue
property ID: Handle
value: http://hdl.handle.net/11427/30009