16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

ASSESSING THE ROLE OF TREATMENT SUPPORT SPECIALIST (TSS) IN PEPFAR ADHERENCE PROGRAM IN NIGERIA

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. ThLB0505

H. Ibrahim¹, J. Kohler¹, S. Gurumdi¹, A. Habib¹, P. Dakum², J. Farley², W. Blattner³, M. Eng^3
1Institute of Human Virology, Clinical Services, Abuja, Nigeria, ²Institute of Human Virology, Abuja, Nigeria, ³Institute of Human Virology, University of Maryland, Boltimore, United States

ISSUES: Inadequate adherence may result in inadequate drug concentrations, incomplete inhibition of HIV replication and may accelerate viral resistance. Drug resistance is a cause for concern in Nigeria, particularly because of the few options for second- and third-line therapy. A patient who fails on his or her first regimen due to drug resistance will have few treatment options left. Non adherence is one of the major factors of drug resistance.

DESCRIPTION: This is an observational study of the adherence activity at one of the PEPFAR- ACTION project sites in the North. Prior to the ACTION project, adherence services for HIV patients on medication did not exist, though the Government of Nigeria started its ART program in 2000 in hospitals across the states.

According to ACTION, if a physician places a patient on ARVs, the adherence counselor prepares the patient to develop a treatment plan. An increasing number of patients’ get access to care and treatment at ACTION sites, and many of these patients come from the local/neighboring communities. Adherence requires continual attention and monitoring, requiring exploration of additional avenues to assist with patients’ medication adherence.

Non clinicians do provide adherence support to overcome possible barriers. These are HIV+ peers referred to as Treatment Support Specialists who can relate to patients in a different way from formal health-care workers’ style. They counsel patients both in the facility and at home.

LESSONS LEARNED: This approach has a positive impact on patients’ adherence efforts because of increased treatment literacy, which is evident by the less time, spent with adherence counselors especially those visited and assisted at home by TSS. Family members are motivated to give social support to clients thereby reducing the problems of stigmatization.

RECOMMENDATIONS:

1. Reinforcement of treatment adherence at multiple levels of interventions.
2. Enhancement of TSS on health care team system for social support.

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2006-08-13
ThLB0505

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