Evaluation of the impact of a community health agent intervention on antiretroviral therapy retention and adherence in Tanzania
Given the problem with retention in, and linkage to, HIV care and treatment and the need for a systematic Community-based HIV/AIDS services (CBHS) intervention in Tanzania is essential. It is anticipated that implementation of CBHS providers enhances service package to improve retention in HIV care and treatment, which will include ART provision for eligible clients and health screening by CBHS providers at the community level. To test this hypothesis, we will recruit cohort of 3,300 people newly diagnosed with HIV at 20 sites in three regions of Tanzania (Pwani, Mbeya, and Kagera). We use a randomized cluster study design with facilities as the clusters to test a well-defined intervention using CBHS providers within intervention health facilities and their related communities. This will enable us to compare program enrollment rates, retention rates, other health outcomes, and viral load (VL) measures between clients enrolled at intervention sites to clients enrolled at control sites. This evaluation aims to determine impact of a coordinated, integrated model of CBHS delivery at community level. The results will improve understanding of how CBHS providers can contribute to the HIV continuum of care and provide an evidence base to inform the development of GOT policies and programmatic guidelines surrounding use of CBHS providers.