Open AccessA Randomized Controlled Trial of the Shikamana Intervention to Promote Antiretroviral Therapy Adherence Among Gay, Bisexual, and Other Men Who Have Sex with Men in Kenya: Feasibility, Acceptability, Safety and Initial Effect Size
Author(s) -
Susan M. Graham,
Murugi Micheni,
Oscar Chirro,
Joseph Nzioka,
Andrew M. Secor,
Peter Mwangi Mugo,
Bernadette Kombo,
Elise van der Elst,
Don Operario,
K Rivet Amico,
Eduard J. Sanders,
Jane M. Simoni
Publication year - 2020
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-020-02786-5
Subject(s) - randomized controlled trial , men who have sex with men , health psychology , medicine , intervention (counseling) , public health , odds , psychological intervention , stigma (botany) , viral load , clinical psychology , physical therapy , family medicine , human immunodeficiency virus (hiv) , psychiatry , logistic regression , nursing , syphilis
Gay, bisexual, and other men who have sex with men (GBMSM) living with HIV in rights-constrained settings need support for antiretroviral therapy (ART) adherence due to barriers including stigma. The Shikamana intervention combined modified Next Step Counseling by providers with support from trained peers to improve adherence among GBMSM living with HIV in Kenya. A randomized controlled trial with 6-month follow-up was used to determine feasibility, acceptability, safety, and initial intervention effects. Generalized estimating equations examined differences in self-reported adherence and virologic suppression. Sixty men enrolled, with 27 randomly assigned to the intervention and 33 to standard care. Retention did not differ by arm, and no adverse events occurred. Feedback on feasibility and acceptability was positive based on exit interviews. After adjustment for baseline viral suppression and confounding, the intervention group had a sixfold increased odds of viral suppression during follow-up. A larger trial of a scaled-up intervention is needed.