Effects of a Facility-Based Intervention on Knowledge, Attitude and Practice Regarding HIV Treatment Outcomes among Adolescents-and-Young-Adults on ART in Nigeria
Abstract:
Adolescents and young
adults living with HIV (AYALHIV) face significant challenges in achieving
optimal HIV treatment outcomes, including viral load suppression. This study
aimed to evaluate the effectiveness of the Operation Triple Zero (OTZ)
intervention in improving knowledge, attitude and practice (KAP) regarding
antiretroviral therapy (ART) adherence and viral suppression among AYALHIV in
Nigeria. A longitudinal clinical-ecological research design was employed with
228 AYALHIV on ART enrolled into the OTZ intervention across five health
facilities in Niger state, north-central Nigeria from June to November 2023. Data
was collected at baseline before the commencement of the intervention and at
six months into the intervention (end line) using an interviewer-administered
semi-structured questionnaire. Informed consent and/or assent were obtained
from study participants and/or their caregivers, and ethical approval was
obtained before commencement of the study. The majority of participants (51%)
were female, 62% were older adolescents aged 15-19 years, 78.9% had had
secondary education, and 98% were single. The study found improvements in KAP
regarding ART adherence and viral suppression among participants after the OTZ
intervention. However, no significant differences were observed in KAP scores
between baseline and end-line assessments (p≤0.05). The OTZ intervention
demonstrated potential in improving KAP regarding ART adherence and viral
suppression among AYALHIV in Nigeria. Further research is needed to explore the
long-term effects of the intervention and to identify strategies to enhance the
KAP scores.
References:
[1].
Okonji, E. F., Mukumbang, F. C., Orth, Z.,
Vickerman-Delport, S. A., and Van Wyk, B., 2020, Psychosocial support
interventions for improved adherence and retention in ART care for young people
living with HIV (10–24 years): a scoping review. BMC Public Health, 20(1),
1–11. https://doi.org/10.1186/s12889-020-09717-y
[2].
WHO 2022,
HIV. and AIDS. Available at https://www.who.int/news-room/factsheets/detail/hiv-aids.
Accessed on July 25 2023
[3].
UNAIDS 2020, Fact sheet–World Aids Day
2020, global HIV statistics. Available at aidsinfo.unaids.org, Retrieved 22
February, 2021.
[4].
UNICEF 2022, HIV statistics-Global and
Regional Trend. Available at www.data.unicef.org. Accessed 19 July, 2024.
[5].
Wong, V. J., Murray, K. R., Phelps, B. R.,
Vermund, S. H. and Mccarraher, D. R., 2018, Adolescents, young people, and the
90–90–90 goals: a call to improve HIV testing and linkage to treatment. Journal of AIDS, 191–194.
[6].
Ulunta, J. C., Ugwuanyi, D., Okafor, J.,
Chukwuka, L., Atere, A. O., Ferdinand, O., and John, E., 2022, Impacts of
Operation Triple Zero (OTZ) Club Support Group on Anti-Retroviral Therapy (Art)
Adherence among Adolescents in Enugu State. Nigerian Journal of Social
Psychology, 5(2), 1–13.
[7].
Tapera, T., Willis, N., Madzeke, K.,
Napei, T., Mawodzeke, M., Chamoko, S., and Kumar, A. M. V., 2019, Effects of a
Peer-Led Intervention on HIV Care Continuum Outcomes Among Contacts of
Children, Adolescents, and Young Adults Living With HIV in Zimbabwe. Global
Health, Science and Practice, 7(4), 575–584. https://doi.org/10.9745/GHSP-D-19-00210
[8].
Schotanus-Dijkstra, M., Drossaert, C. H.
C., Pieterse, M. E., Boon, B., Walburg, J. A., and Bohlmeijer, E. T., 2017, An
early intervention to promote well-being and flourishing and reduce anxiety and
depression: A randomized controlled trial. Internet Interventions, 9(April),
15–24. https://doi.org/10.1016/j.invent.2017.04.002
[9].
Tafere, G. W., Hunduma, F. and Yesyf, A.,
Viral suppression rate at operation triple zero (OTZ) and regular ART follow-up
programs and associated factors among adolescent clients of Addis
AbabaEthiopia: A comparative cross-sectional study. Virol J.
20,208 2023. https://doi.org/10.1186/s12985-023-02176-y
[10]. Emerenini,
F., Fayorsey, R., Fadare, O., Okwor, E., Umahi, I., Orisayomi, S., and Atuma,
E., 2021, Optimizing antiretroviral treatment and viral suppression for
adolescents and young people living with HIV by implementing Operation Triple
Zero (OTZ) in four states in Nigeria. Journal of the International AIDS
Society, 24(S4), 61–62.
[11]. PEPFAR
Solutions Platform, 2018, Operation Triple Zero: Empowering Adolescents and
Young People Living with HIV to Take Control of Their Health. https://www.pepfarsolutions.org/solutions/2018/10/30/operation-triple-zero-empowering-adolescents-and-young-people-living-with-hiv-to-take-control-of-their-own-health#:~:text=Operation%20Triple%20Zero%20%28OTZ%29%20engages%20AYPLHIV%20as%20active,package%2C%20and%20are%20empowered%20to%20be%20self-health%20managers.8/11/21
[12]. Nubed,
C. K., and Akoachere, J. F. T. K., 2016, Knowledge, attitudes and practices
regarding HIV/AIDS among senior secondary school students in Fako Division, Southwest
Region, Cameroon. BMC Public Health, 16(1), 1–10. https://doi.org/10.1186/s12889-016-3516-9
[13]. Aderemi-Williams,
R. I., Razaq, A. R., Abah, I. O., Opanuga, O. O., and Akanmu, A. S., 2021,
Adolescents and Young Adults Knowledge, Adherence and Experiences While on
Antiretroviral Therapy in a Tertiary Hospital in Lagos, Nigeria: A Mixed-Method
Study. J Int Assoc Provid AIDS Care, 9(20):23259582211062754. doi:
10.1177/23259582211062754
[14]. Adhiombo,
O. L., Exploring the Disparities between Health Knowledge and adherence among
adolescents living with HIV on second-line Antiretroviral Therapy in Rural
Western Kenya. Journal of Health Literacy.
Spring 2024; 9(1):38-52
[15]. Kavya,
P., Daniel, S., Shumayla, S., Sinha, R., and Mehra, S., 2020, Effectiveness of
Peer-Led Intervention on KAP Related to Sexual Reproductive and Mental Health
Issues among Adolescents in Low Resource Settings India: A comparative study
among Participants and Non-Participants in the Intervention. Health, 12, 1151-1168
[16]. Fisher, J. D., and
Fisher, W. A., Changing AIDS-risk behavior. Psychol Bull. 1992
May;111(3):455-74. doi: 10.1037/0033-2909.111.3.455. PMID: 1594721.
[17]. Dixon-Umo,
O. T., and Ikpeme, E. E., 2020, Viral suppression and predictors among
adolescents receiving care for HIV/AIDS in a tertiary health centre in Uyo,
South-South, Nigeria. Journal of AIDS and HIV Research, 12(2),
9–16. https://doi.org/10.5897/jahr2020.0510
[18]. Kasumu,
L. O., and Balogun, M. R., 2014, Knowledge and Attitude towards Antiretroviral
Therapy and Adhrence pattern of HIV patients in southwest Nigeria. International Journal of Infection Control
2014 DOI: 10. 3396IJIC.v10i3.024.14
[19]. Raberahona,
M., Lidamahasolo, Z., Andriamamonjisoa, J., Andriananja, V., Andrianasolo, R.
L., Rakotoarivelo, R. A., and Randria, M. J. D. D., 2019, Knowledge, attitudes,
perception and practices regarding antiretroviral therapy among HIV-infected
adults in Antananarivo, Madagascar: A cross-sectional survey. BMC Health
Services Research, 19(1), 1–9. https://doi.org/10.1186/s12913-019-4173-3
[20]. Idele,
P., Gillespie, A., Porth, T., Suzuki, C., Mahy, M., Kasedde, S., and Luo, C.,
2014, Epidemiology of HIV and AIDS among adolescents: Current status,
inequities, and data gaps. Journal of Acquired Immune Deficiency Syndromes,
66(SUPPL. 2). https://doi.org/10.1 097/QAI.0000000000000176
[21]. Dulli,
L., Ridgeway, K., Packer, C., Murray, K. R., Mumuni, T., Plourde, K. F., Chen,
M., Olumide, A., Ojengbede, O., and McCarraher, D. R., 2020, A Social
Media–Based Support Group for Youth Living with HIV in Nigeria (SMART
Connections): Randomized Controlled Trial. Med Internet Res, 22(6),
1-17. doi: 10.2196/18343
[22]. Akuiyibo,
S., Anyanti, J., Idogho, O., Piot, S., Amoo, B., Nwankwo, N., and Anosike, N.,
2021, Impact of peer education on sexual health knowledge among adolescents and
young persons in two North Western states of Nigeria. Reproductive Health
(2021) 18:204
[23]. MacCarthy,
S., Saya, U., Samba, C., Josephine Birungi, J., Okoboi, S., and Linnemayr, S.,
2018, How am I going to live?”: exploring barriers to ART adherence among
adolescents and young adults living with HIV in Uganda. BMC Public Health,
18:1158. https://doi.org/10.1186/s12889-018-6048-7
[24]. Deeks,
S. G., Archin, N., Cannon, P., Collins, S., Jones, R. B., de Jong, M. A. W. P.,
Lambotte, O., Lamplough, R., Ndung’u, T., Sugarman, J., Tiemessen, C. T.,
Vandekerckhove, L., and Lewin, S. R., 2021, Research priorities for an HIV
cure: International AIDS Society Global Scientific Strategy 2021. Nat Med,
27, 2085–2098 (2021). https://doi.org/10.1038/s41591-021-01590-5
[25]. Biudes,
M. F., and Galato, D., 2014, Self-Medication in Patients Living with HIV/AIDS: Little
Measured Reality. https://api.semanticscholar.org/CorpusID:53681294
[26]. Adedoyin, A., Fadahunsi, G. S., Osinubi, M. O., Ahmed, A., Imhonopi, G. B., Soyannwo, T., and Akinbode, P. A., 2021, Factors associated with viral non-suppression among patients on antiretroviral therapy (ART) at the Federal Medical Centre, Abeokuta, Ogun State, Nigeria. BUMJ, 4(1):8-13. https://doi.org/10.38029/bumj.v4i1.49
