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Understanding Patterns of Social Support and Their Relationship to an ART Adherence Intervention Among Adults in Rural Southwestern Uganda

SMS is a widely used technology globally and may also improve ART adherence, yet SMS notifications to social supporters following real-time detection of missed doses showed no clear benefit in a recent pilot trial. We examine the demographic and social-cultural dynamics that may explain this finding...

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Autores principales: Atukunda, Esther C., Musiimenta, Angella, Musinguzi, Nicholas, Wyatt, Monique A., Ashaba, Justus, Ware, Norma C., Haberer, Jessica E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5288444/
https://www.ncbi.nlm.nih.gov/pubmed/27671479
http://dx.doi.org/10.1007/s10461-016-1559-7
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author Atukunda, Esther C.
Musiimenta, Angella
Musinguzi, Nicholas
Wyatt, Monique A.
Ashaba, Justus
Ware, Norma C.
Haberer, Jessica E.
author_facet Atukunda, Esther C.
Musiimenta, Angella
Musinguzi, Nicholas
Wyatt, Monique A.
Ashaba, Justus
Ware, Norma C.
Haberer, Jessica E.
author_sort Atukunda, Esther C.
collection PubMed
description SMS is a widely used technology globally and may also improve ART adherence, yet SMS notifications to social supporters following real-time detection of missed doses showed no clear benefit in a recent pilot trial. We examine the demographic and social-cultural dynamics that may explain this finding. In the trial, 63 HIV-positive individuals initiating ART received a real-time adherence monitor and were randomized to two types of SMS reminder interventions versus a control (no SMS). SMS notifications were also sent to 45 patient-identified social supporters for sustained adherence lapses. Like participants, social supporters were interviewed at enrollment, following their matched participant’s adherence lapse and at exit. Social supporters with regular income (RR = 0.27, P = 0.001) were significantly associated with fewer adherence lapses. Instrumental support was associated with fewer adherence lapses only among social supporters who were food secure (RR = 0.58, P = 0.003). Qualitative interview data revealed diverse and complex economic and relationship dynamics, affecting social support. Resource availability in emotionally positive relationships seemingly facilitated helpful support, while limited resources prevented active provision of support for many. Effective social support appeared subject to social supporters’ food security, economic stability and a well-functioning social network dependent on trust and supportive disclosure.
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spelling pubmed-52884442017-02-16 Understanding Patterns of Social Support and Their Relationship to an ART Adherence Intervention Among Adults in Rural Southwestern Uganda Atukunda, Esther C. Musiimenta, Angella Musinguzi, Nicholas Wyatt, Monique A. Ashaba, Justus Ware, Norma C. Haberer, Jessica E. AIDS Behav Original Article SMS is a widely used technology globally and may also improve ART adherence, yet SMS notifications to social supporters following real-time detection of missed doses showed no clear benefit in a recent pilot trial. We examine the demographic and social-cultural dynamics that may explain this finding. In the trial, 63 HIV-positive individuals initiating ART received a real-time adherence monitor and were randomized to two types of SMS reminder interventions versus a control (no SMS). SMS notifications were also sent to 45 patient-identified social supporters for sustained adherence lapses. Like participants, social supporters were interviewed at enrollment, following their matched participant’s adherence lapse and at exit. Social supporters with regular income (RR = 0.27, P = 0.001) were significantly associated with fewer adherence lapses. Instrumental support was associated with fewer adherence lapses only among social supporters who were food secure (RR = 0.58, P = 0.003). Qualitative interview data revealed diverse and complex economic and relationship dynamics, affecting social support. Resource availability in emotionally positive relationships seemingly facilitated helpful support, while limited resources prevented active provision of support for many. Effective social support appeared subject to social supporters’ food security, economic stability and a well-functioning social network dependent on trust and supportive disclosure. Springer US 2016-09-26 2017 /pmc/articles/PMC5288444/ /pubmed/27671479 http://dx.doi.org/10.1007/s10461-016-1559-7 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Atukunda, Esther C.
Musiimenta, Angella
Musinguzi, Nicholas
Wyatt, Monique A.
Ashaba, Justus
Ware, Norma C.
Haberer, Jessica E.
Understanding Patterns of Social Support and Their Relationship to an ART Adherence Intervention Among Adults in Rural Southwestern Uganda
title Understanding Patterns of Social Support and Their Relationship to an ART Adherence Intervention Among Adults in Rural Southwestern Uganda
title_full Understanding Patterns of Social Support and Their Relationship to an ART Adherence Intervention Among Adults in Rural Southwestern Uganda
title_fullStr Understanding Patterns of Social Support and Their Relationship to an ART Adherence Intervention Among Adults in Rural Southwestern Uganda
title_full_unstemmed Understanding Patterns of Social Support and Their Relationship to an ART Adherence Intervention Among Adults in Rural Southwestern Uganda
title_short Understanding Patterns of Social Support and Their Relationship to an ART Adherence Intervention Among Adults in Rural Southwestern Uganda
title_sort understanding patterns of social support and their relationship to an art adherence intervention among adults in rural southwestern uganda
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5288444/
https://www.ncbi.nlm.nih.gov/pubmed/27671479
http://dx.doi.org/10.1007/s10461-016-1559-7
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