The Effect of PLHIV Support Groups and Income Generation Activities on Art Adherence and Retention in Care in Magu District, Mwanza Region

Abstract

Background: Poor adherence to ART medication is influenced by many factors including non-disclosure of a positive HIV status and HIV-related stigma. For optimal adherence to ART medicines, implementation of community interventions such as PLHIV support groups is critical in reducing stigma and enhancing disclosure of a positive HIV status. Additionally, income generation activities (IGA) being among the activities done by support groups have a positive link with the level of adherence. Despite the fact that PLHIV support groups have been formulated at both hospital and community settings in Tanzania as well as engagement of group members in income generation activities there is limited information on the effect of PLHIV support groups to ART adherence and retention in care among people living with HIV. Aims of study: This study aimed at determining the effect of PLHIV support group interventions on ART adherence and retention in Care in Magu District, Mwanza Region. Methodology: A cross-sectional study was designed to compare ART adherence rates and retention in care among PLHIV who participate in PLHIV support groups and those who do not. Study population included 252 HIV positive adults on ART receiving care at Magu District Hospital. Study respondents were obtained through systematic random sampling. Data was collected using structured questionnaire with close ended questions. The collected data was processed and analysed using SPSS version 16. Results: The study enrolled 252 participants where majority of them were female (73%), aged above 40 years (53.2%), married (47.6%), had primary education (71%), disclosed HIV status (88.1%), not participating in PLHIV support group (53.6%), engaged in Income Generation activities (73.8%) and kept clinic appointments (90.1%). Respondents aged above 40 years, females, primary school leavers, married, disclosed their HIV status, engaged in income generation activities were more likely to participate in PLHIV support groups which was statistically significant (p=0.000; 0.034; 0.038; 0.002; 0.000 and 0.000) respectively. All clients participated in PLHIV support groups kept their clinic appointments which was statistically significant (p=0.000). Respondents participated in PLHIV support groups, engaged in Income generation activities (OR: 2.36(1.05-5.30 and p<0.05) and disclosed HIV status (aOR: 5.62 (1.01-31.06 and p<0.05) were more adherent to ART and retained in care. Conclusion: The study suggests that there is an association between PLHIV support group activities and Income generation activities and adherence to ART and retention in care: PLHIV who participate in PLHIV support group activities, engage in income generation activities and disclosed HIV status are more likely to adhere to ART and retained in care than those who do not participate. Recommendation: This observation rationalizes investments in strengthening and scaling up the formulation of PLHIV support groups as one of the strategy for promoting social support and enhancing ART adherence and continuity of treatment among People Living with HIV.