Antiretroviral therapy adherence and the youth: An assessment of teen clubs’ implementation fidelity in southern Malawi

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Date
2020-03-01
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Globallythereare2.1millionadolescentslivingwithHIV.1.7millionarein subSaharanAfrica.MalawihasoneofthehighestHIV/AIDSprevalenceratesinthe worldwith12.0%ofthoseaged15-49yearsinfected.AdherencetoARThasprovedto bedifficultforpeoplelivingwithHIVandoftenfallsbelowtherequiredlevelsandthus, youthslivingwithHIVareamongthepopulationgroupswithpoorerARTadherence rates.Fidelityisdefinedasadherence,integrityandqualityofimplementationofan intervention.HoweverhighlevelsofadherencearecrucialtothesuccessofHIV therapiesinordertosustainviralsuppression. Objective:ToassessthefidelityofimplementingteenclubsdesignedtoenhanceART adherenceinBlantyreDistrict WeconductedaFormativeEvaluationQualitativeResearchthatwasguided byaConsolidated FrameworkforImplementationResearchusing KeyInformant Interviewstoestablishifteenclubinterventionisimplementedwithfidelity.Thestudy wasconductedinfiveBlantyreHealthCentreTeenClubsnamely:Chilomoni,Chileka, SouthLunzu,Mpemba,NdirandeandLightHouseClinicatQueenElizabethCentral Hospital. Weusedacasestudymethodandpurposivesampling.Eligiblestudy participantswereteenclubfacilitatorswhohavefacilitatedteenclubsforatleasta year.IndepthInterviewswereaudiorecordedandthentranscribedverbatim.Thematic contentanalysiswasusedtoanalyzethedatamanually. HalfofthesampledteenclubshadguidelinesforconductingTeenClub Activities.TheexistedguidelinescompliedwiththeBaylorInternationalPediatricsAIDS Initiative.However,someelementswerenotfollowed.Trainingoftheteenclub vi facilitatorswasoneofthefactorsthatinfluencedcompliancewiththeguidelines. From theresults,theassessmenthasgeneratedinformationonattributes thatleadtocomplianceandnoncomplianceofHIVteenclubguidelinesinrelationto implementationfidelityoftheteenclubintervention.Ateenclubcannotbeoperated withoutthedesignatedguidelinesthatareestablishedtobefollowedassuchthey shouldbecompliedwith.
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