Using Community Health Workers to Improve Clinical Outcomes Among People Living with HIV: A Randomized Controlled Trial

Springer Science and Business Media LLC - Tập 17 - Trang 2927-2934 - 2013
Sonjia Kenya1, Jamal Jones2, Kristopher Arheart3, Erin Kobetz4, Natasha Chida2, Shelly Baer5, Alexis Powell6, Stephen Symes7, Tai Hunte2, Anne Monroe2, Olveen Carrasquillo1
1Division of General Medicine, Jay Weiss Center Social Medicine and Health Equity, University of Miami Miller School of Medicine, Miami, USA
2Jay Weiss Center for Social Medicine and Health Equity, University of Miami Miller School of Medicine, Miami, USA
3Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, USA
4Department of Epidemiology and Public Health, Jay Weiss Center for Social Medicine and Health Equity, University of Miami Miller School of Medicine, Miami, USA
5Department of Pediatrics, Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, USA
6Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, USA
7Division of Infectious Diseases, Jay Weiss Center Social Medicine and Health Equity, University of Miami Miller School of Medicine, Miami, USA

Tóm tắt

AIDS-related mortality remains a leading cause of preventable death among African-Americans. We sought to determine if community health workers could improve clinical outcomes among vulnerable African-Americans living with HIV in Miami, Florida. We recruited 91 medically indigent persons with HIV viral loads ≥1,000 and/or a CD4 cell count ≤350. Patients were randomized to a community health worker (CHW) intervention or control group. Viral load and CD4 cell count data were abstracted from electronic medical records. At 12 months, the mean VL in the intervention group was log 0.9 copies/μL lower than the control group. The CD4 counts were not significantly different among the groups. Compared to the control group, patients randomized to CHWs experienced statistically significant improvements in HIV viral load. Larger multi-site studies of longer duration are needed to determine whether CHWs should be incorporated into standard treatment models for vulnerable populations living with HIV.

Tài liệu tham khảo

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