Assessing the impact of HIV support groups on antiretroviral therapy adherence and viral suppression in the African cohort study
Authors: Mbah Prudence , Iroezindu Michael , Esber Allahna L. , Dear Nicole , Reed Domonique , Adamu Yakubu , Tiamiyu Abdulwasiu Bolaji , Mohammed Samirah Sani , Kibuuka Hannah , Maswai Jonah , Owuoth John , Bahemana Emmanuel , Ake Julie A. , Polyak Christina S. , Crowell Trevor A. ,   for the AFRICOS Study Group, Bartolanzo Danielle , Reynolds Alexus , Song Katherine , Milazzo Mark , Francisco Leilani , Schech Steven , Omar Badryah , Mebrahtu Tsedal , Lee Elizabeth , Bohince Kimberly , Parikh Ajay , Hern Jaclyn , Duff Emma , Lombardi Kara , Imbach Michelle , Elle Leigh Anne , Semwogerere Michael , Naluyima Prossy , Zziwa Godfrey , Tindikahwa Allan , Bagenda Claire Nakazzi , Mutebe Hilda , Kafeero Cate , Baghendaghe Enos , Lwebuge William , Ssentogo Freddie , Birungi Hellen , Tegamanyi Josephine , Wangiri Paul , Nabanoba Christine , Namulondo Phiona , Tumusiime Richard , Musingye Ezra , Nanteza Christina , Wandege Joseph , Waiswa Michael , Najjuma Evelyn , Maggaga Olive , Kenoly Isaac Kato , Mukanza Barbara , Millard Monica , Langat Rither , Ngeno Aaron , Korir Lucy , Langat Raphael , Opiyo Francis , Kasembeli Alex , Ochieng Christopher , Towett Japhet , Kimetto Jane , Omondi Brighton , Leelgo Mary , Obonyo Michael , Rotich Linner , Tonui Enock , Chelangat Ella , Kapkiai Joan , Wangare Salome , Kesi Zeddy Bett , Ngeno Janet , Langat Edwin , Labosso Kennedy , Rotich Joshua , Cheruiyot Leonard , Changwony Enock , Bii Mike , Chumba Ezekiel , Ontango Susan , Gitonga Danson , Kiprotich Samuel , Ngtech Bornes , Engoke Grace , Metet Irene , Airo Alice , Kiptoo Ignatius , Sing’oei Valentine , Rehema Winnie , Otieno Solomon , Ogari Celine , Modi Elkanah , Adimo Oscar , Okwaro Charles , Lando Christine , Onyango Margaret , Aoko Iddah , Obambo Kennedy , Meyo Joseph , Suja George , Chittenden Laura , Azuakola Nnamdi , Asuquo Mfreke , Kokogho Afoke , Mohammed Samirah Sani , Okoye Ifeanyi , Odeyemi Sunday , Suleiman Aminu , Umeji Lawrence C. , Enas Onome , Ayogu Miriam , Chigbu-Ukaegbu Ijeoma , Adai Wilson , Odo Felicia Anayochukwu , Abdu Rabi , Akiga Roseline , Nwandu Helen , Okolo Chisara Sylvestina , Taiwo Ogundele , Ben Otene Oche , Eigege Nicholas Innocent , Musa Tony Ibrahim , Joseph Juliet Chibuzor , Okeke Ndubuisi C. , Parker Zahra , Harrison Nkechinyere Elizabeth , Agbaim Uzoamaka Concilia , Adegbite Olutunde Ademola , Asogwa Ugochukwu Linus , Adelakun Adewale , Ekeocha Chioma , Idi Victoria , Eluwa Rachel , Nwalozie Jumoke Titilayo , Faith Igiri , Wilson Blessing Irekpitan , Elemere Jacinta , Nnadi Nkiru , Idowu Francis Falaju , Rosemary Ndubuisi , Uzoegwu Amaka Natalie , Obende Theresa Owanza , Obilor Ifeoma Lauretta , Emekaili Doris , Akinwale Edward , Ochai Inalegwu , Maganga Lucas , Khamadi Samoel , Njegite John , Lueer Connie , Kisinda Abisai , Mwamwaja Jaquiline , Mbwayu Faraja , David Gloria , Mwaipopo Mtasi , Gervas Reginald , Mkondoo Dorothy , Somi Nancy , Kiliba Paschal , Mwalongo Ephrasia , Mwaisanga Gwamaka , Msigwa Johnisius , Mfumbulwa Hawa , Edwin Peter , Olomi Willyhelmina 
Published: July 2021

Abstract
Background
Support groups for people living with HIV (PLWH) may improve HIV care adherence and outcomes. We assessed the impact of support group attendance on antiretroviral therapy (ART) adherence and viral suppression in four African countries.

Methods
The ongoing African Cohort Study (AFRICOS) enrolls participants at 12 clinics in Kenya, Uganda, Tanzania, and Nigeria. Self-reported attendance of any support group meetings, self-reported ART adherence, and HIV RNA are assessed every 6 months. Logistic regression models with generalized estimating equations were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for support group attendance and other factors potentially associated with ART adherence and viral suppression.

Results
From January 2013 to December 1, 2019, 1959 ART-experienced PLWH were enrolled and 320 (16.3%) reported any support group attendance prior to enrollment. Complete ART adherence, with no missed doses in the last 30 days, was reported by 87.8% while 92.4% had viral suppression <1000copies/mL across all available visits. There was no association between support group attendance and ART adherence in unadjusted (OR 1.01, 95% CI 0.99–1.03) or adjusted analyses (aOR 1.00, 95% CI 0.98–1.02). Compared to PLWH who did not report support group attendance, those who did had similar odds of viral suppression in unadjusted (OR 0.99, 95% CI 0.978–1.01) and adjusted analyses (aOR 0.99, 95% CI 0.97–1.01).

Conclusion
Support group attendance was not associated with significantly improved ART adherence or viral suppression, although low support group uptake may have limited our ability to detect a statistically significant impact.