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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Abstract
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.