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AIDS Research and Treatment
Volume 2014 (2014), Article ID 137545, 9 pages
http://dx.doi.org/10.1155/2014/137545
Research Article

Adapting and Implementing a Community Program to Improve Retention in Care among Patients with HIV in Southern Haiti: “Group of 6”

1The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, USA
2Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
3Centres GHESKIO, Port-au-Prince, Haiti
4Hôpital Immaculée Conception, Les Cayes, Southern Department, Haiti
5Geisel School of Medicine at Dartmouth, Hanover, NH, USA
6United States Centers for Disease Control and Prevention, Les Cayes, Southern Department, Haiti
7Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
8Division of Infectious Disease and International Health, Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
9Center for Global Health, Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, NY, USA

Received 13 August 2014; Accepted 12 November 2014; Published 7 December 2014

Academic Editor: Robert R. Redfield

Copyright © 2014 John A. Naslund et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. In Mozambique, a patient-led Community ART Group model developed by Médecins Sans Frontières improved retention in care and adherence to antiretroviral therapy (ART) among persons with HIV. We describe the adaptation and implementation of this model within the HIV clinic located in the largest public hospital in Haiti’s Southern Department. Methods. Our adapted model was named Group of 6. Hospital staff enabled stable patients with HIV receiving ART to form community groups with 4–6 members to facilitate monthly ART distribution, track progress and adherence, and provide support. Implementation outcomes included recruitment success, participant retention, group completion of monthly monitoring forms, and satisfaction surveys. Results. Over one year, 80 patients from nine communities enrolled into 15 groups. Six participants left to receive HIV care elsewhere, two moved away, and one died of a non-HIV condition. Group members successfully completed monthly ART distribution and returned 85.6% of the monthly monitoring forms. Members reported that Group of 6 made their HIV management easier and hospital staff reported that it reduced their workload. Conclusions. We report successful adaptation and implementation of a validated community HIV-care model in Southern Haiti. Group of 6 can reduce barriers to ART adherence, and will be integrated as a routine care option.