Preliminary Effects of an Urban Gardens and Peer Nutritional Counseling Intervention on HIV Treatment Adherence and Detectable Viral Load Among People with HIV and Food Insecurity: Evidence from a Pilot Cluster Randomized Controlled Trial in the Dominican Republic.
Adherence
Dominican Republic
Food insecurity
HIV
Urban gardens
Viral suppression
Journal
AIDS and behavior
ISSN: 1573-3254
Titre abrégé: AIDS Behav
Pays: United States
ID NLM: 9712133
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
accepted:
18
08
2022
pubmed:
7
9
2022
medline:
25
2
2023
entrez:
6
9
2022
Statut:
ppublish
Résumé
A pilot cluster randomized controlled trial involving two HIV clinics in the Dominican Republic assessed preliminary efficacy of an urban garden and peer nutritional counseling intervention. A total of 115 participants (52 intervention, 63 control) with moderate or severe food insecurity and sub-optimal antiretroviral therapy (ART) adherence and/or detectable viral load were assessed at baseline, 6- and 12-months. Longitudinal multivariate regression analysis controlling for socio-demographics and accounting for serial cluster correlation found that the intervention: reduced the prevalence of detectable viral load by 20 percentage points at 12 months; reduced any missed clinic appointments by 34 and 16 percentage points at 6 and 12 months; increased the probability of "perfect" ART adherence by 24 and 20 percentage points at 6 and 12 months; and decreased food insecurity at 6 and 12 months. Results are promising and warrant a larger controlled trial to establish intervention efficacy for improving HIV clinical outcomes.Trial registry Clinical Trials Identifier: NCT03568682. Un estudio piloto de un ensayo controlado aleatorio por conglomerados que involucró a dos clínicas del VIH en la República Dominicana evaluó de forma preliminar la eficacia de una intervención de huertos urbanos y consejería nutricional entre pares. Un total de 115 participantes (52 de intervención, 63 de control) con inseguridad alimentaria moderada o grave y con adherencia subóptima a la terapia antirretroviral (TARV) y/o carga viral detectable fueron evaluados al inicio del estudio, y a los 6 y 12 meses. El análisis de regresión longitudinal multivariada controlando por variables sociodemográficas y tomando en cuenta la correlación serial de clúster encontró que la intervención: redujo la prevalencia de carga viral detectable en 20 puntos porcentuales a los 12 meses; redujo las citas clínicas perdidas en 34 y 16 puntos porcentuales a los 6 y 12 meses; aumentó la probabilidad de adherencia “perfecta” al TARV en 24 y 20 puntos porcentuales a los 6 y 12 meses; y disminuyó la inseguridad alimentaria a los 6 y 12 meses. Los resultados son prometedores y justifican un ensayo controlado más grande para establecer la eficacia de la intervención en mejorar los resultados clínicos del VIH.
Autres résumés
Type: Publisher
(fre)
Un estudio piloto de un ensayo controlado aleatorio por conglomerados que involucró a dos clínicas del VIH en la República Dominicana evaluó de forma preliminar la eficacia de una intervención de huertos urbanos y consejería nutricional entre pares. Un total de 115 participantes (52 de intervención, 63 de control) con inseguridad alimentaria moderada o grave y con adherencia subóptima a la terapia antirretroviral (TARV) y/o carga viral detectable fueron evaluados al inicio del estudio, y a los 6 y 12 meses. El análisis de regresión longitudinal multivariada controlando por variables sociodemográficas y tomando en cuenta la correlación serial de clúster encontró que la intervención: redujo la prevalencia de carga viral detectable en 20 puntos porcentuales a los 12 meses; redujo las citas clínicas perdidas en 34 y 16 puntos porcentuales a los 6 y 12 meses; aumentó la probabilidad de adherencia “perfecta” al TARV en 24 y 20 puntos porcentuales a los 6 y 12 meses; y disminuyó la inseguridad alimentaria a los 6 y 12 meses. Los resultados son prometedores y justifican un ensayo controlado más grande para establecer la eficacia de la intervención en mejorar los resultados clínicos del VIH.
Identifiants
pubmed: 36066760
doi: 10.1007/s10461-022-03821-3
pii: 10.1007/s10461-022-03821-3
pmc: PMC9446649
doi:
Substances chimiques
Anti-Retroviral Agents
0
Banques de données
ClinicalTrials.gov
['NCT03568682']
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
864-874Subventions
Organisme : National Institute of Mental Health
ID : R34MH110325
Organisme : NIDDK NIH HHS
ID : K01 DK107335
Pays : United States
Organisme : University of California, San Francisco
ID : P30AI027763
Organisme : NIDDK NIH HHS
ID : K01DK107335
Pays : United States
Organisme : National Institute of Diabetes and Digestive and Kidney Diseases
ID : K01DK107335
Organisme : NIMH NIH HHS
ID : R34MH110325
Pays : United States
Organisme : NIMH NIH HHS
ID : R34 MH110325
Pays : United States
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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