IMPACT OF AN INTERVENTION TO IMPROVE ART ADHERENCE AMONG RURAL INDIAN WOMEN WITH AIDS

2.50
Hdl Handle:
http://hdl.handle.net/10755/211739
Type:
Research Study
Title:
IMPACT OF AN INTERVENTION TO IMPROVE ART ADHERENCE AMONG RURAL INDIAN WOMEN WITH AIDS
Abstract:
Purpose: To assess the impact of an innovative intervention delivered by lay village women in India, Ashas, on improving antiretroviral therapy (ART) compliance and psychological and physical health of rural women living with AIDS (WLA) in India. Background: WLA in India continue to face profound challenges in accessing and following treatment regimens, caring for family members, and maintaining positive mental health. In 2005, the Government of India launched a National Rural Health Mission to address the health needs of the rural population by engaging Ashas, lay village women who interface with nurse midwives and physicians at local primary health centers. Ashas in India have predominantly focused on reproductive health for pregnant and postpartum women and infant wellbeing; however, the investigators trained Ashas to improve the adherence of rural WLA and enhance their physical and psychological health. Method: A prospective, randomized clinical trial was utilized to assess the outcomes of an innovative theoretically-based Asha Life intervention on ART compliance and physical and psychological health among 68 WLA. These WLA, residing in one of two villages, were randomized into Asha Life (AL) or usual care (UC) groups. Ashas worked closely with nurses and other health care providers, focused on providing supportive care and overcoming the barriers to compliance of ART. These included illness, difficulty in transportation, etc. WLA were eligible if they were between the ages of 18-45; and 2) screened as receiving ART for a minimum of three months. Structured instruments assessed ART adherence, depressive symptoms and body composition. Additionally, percent body fat, fat and lean mass were measured with a 310e Bioimpedance analyzer. Findings: At six-month follow-up, findings revealed that adherence was significantly improved ranging from 93% -100% for the AL group (mean 99%; 0.02) and 60% - 95% for the UC group (mean 67%, 0.22). In multivariate analyses, the AL participants also had significantly greater odds of reducing depressive symptoms, improving CD4 levels and weight, BMI, percent fat, fat weight, and lean weight significantly higher in the AL group compared to the UC group. Implications: The findings provide a basis for addressing the challenges which rural WLA face and support the AL intervention which focuses on supportive care, education, overcoming barriers to care. As a package, the AL intervention was significant in impacting the outcomes assessed.
Keywords:
AIDS; India; Antiretroviral therapy
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5105
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleIMPACT OF AN INTERVENTION TO IMPROVE ART ADHERENCE AMONG RURAL INDIAN WOMEN WITH AIDSen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211739-
dc.description.abstractPurpose: To assess the impact of an innovative intervention delivered by lay village women in India, Ashas, on improving antiretroviral therapy (ART) compliance and psychological and physical health of rural women living with AIDS (WLA) in India. Background: WLA in India continue to face profound challenges in accessing and following treatment regimens, caring for family members, and maintaining positive mental health. In 2005, the Government of India launched a National Rural Health Mission to address the health needs of the rural population by engaging Ashas, lay village women who interface with nurse midwives and physicians at local primary health centers. Ashas in India have predominantly focused on reproductive health for pregnant and postpartum women and infant wellbeing; however, the investigators trained Ashas to improve the adherence of rural WLA and enhance their physical and psychological health. Method: A prospective, randomized clinical trial was utilized to assess the outcomes of an innovative theoretically-based Asha Life intervention on ART compliance and physical and psychological health among 68 WLA. These WLA, residing in one of two villages, were randomized into Asha Life (AL) or usual care (UC) groups. Ashas worked closely with nurses and other health care providers, focused on providing supportive care and overcoming the barriers to compliance of ART. These included illness, difficulty in transportation, etc. WLA were eligible if they were between the ages of 18-45; and 2) screened as receiving ART for a minimum of three months. Structured instruments assessed ART adherence, depressive symptoms and body composition. Additionally, percent body fat, fat and lean mass were measured with a 310e Bioimpedance analyzer. Findings: At six-month follow-up, findings revealed that adherence was significantly improved ranging from 93% -100% for the AL group (mean 99%; 0.02) and 60% - 95% for the UC group (mean 67%, 0.22). In multivariate analyses, the AL participants also had significantly greater odds of reducing depressive symptoms, improving CD4 levels and weight, BMI, percent fat, fat weight, and lean weight significantly higher in the AL group compared to the UC group. Implications: The findings provide a basis for addressing the challenges which rural WLA face and support the AL intervention which focuses on supportive care, education, overcoming barriers to care. As a package, the AL intervention was significant in impacting the outcomes assessed.en_GB
dc.subjectAIDSen_GB
dc.subjectIndiaen_GB
dc.subjectAntiretroviral therapyen_GB
dc.date.available2012-02-20T12:11:28Z-
dc.date.issued2012-02-20T12:11:28Z-
dc.date.accessioned2012-02-20T12:11:28Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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