Research Article | | Peer-Reviewed

A Case Study on the Community ART Group Model of Care: Does It work for People Living with HIV and Healthcare Service Providers in Lesotho

Received: 23 May 2024     Accepted: 17 July 2024     Published: 31 July 2024
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Abstract

The Community ART Group (CAG) model is a community-led model implemented to support people living with HIV to address barriers to HIV treatment continuity which remain a challenge in Lesotho. This study sought to explore the perspectives of people living with HIV and that of the healthcare service providers, regarding the CAG model in selected health facilities in Lesotho. An explorative descriptive qualitative study was conducted among purposively selected 20 people living with HIV and 8 healthcare service providers at 3 healthcare facilities. Qualitative data were collected through face-to-face in-depth interviews using semi-structured interview guides. All interviews were audio-recorded and transcribed verbatim. Thematic analysis was used following an inductive approach and sub-themes and themes were developed. The CAG model was relevant and acceptable to most of the respondents. They felt that it provided support to people living with HIV, promoted good adherence to treatment, improved treatment access, reduced transport costs, saved time, and reduced stigma. Good retention, favorable clinical outcomes and decongestion of health facilities were identified as key achievements linked to the CAG model. Age, proximity to the health facilities, readiness to disclose positive HIV status, availability of a variety of differentiated service delivery models, family support, and the level of trust emerged as factors affecting the acceptability of the model. Conflicts arising among members of the groups compromised service delivery quality and insufficient resources emerged as challenges. The results confirmed that the Community ART Group model can deliver intended peer-led support to People Living with HIV, resulting in the achievement of favorable clinical outcomes. It is therefore recommendable to consider investing in this community-led model for a sustained HIV response in the country.

Published in American Journal of Nursing Science (Volume 13, Issue 4)
DOI 10.11648/j.ajns.20241304.12
Page(s) 77-85
Creative Commons

This is an Open Access article, 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 or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Perspectives, PLHIV, Healthcare Service Providers, Community ART Group Model, Health Facilities, Lesotho

References
[1] WHO, 2021. “Updated Recommendations on service delivery for the treatment and care of People Living with HIV.” Geneva: World Health Organization, pp. xi – 16. Available from:
[2] LEPHIA Survey., 2020. Preliminary Report. Maseru: U.S. Embassy Lesotho Available from:
[3] Kuchukhidze, S., Long. L., Pascoe, S. and Nichols, B., et al., 2019. “Differentiated models of service delivery for antiretroviral treatment of HIV in sub-Saharan Africa: a rapid review protocol”. Systematic Reviews. 8(314).
[4] UNAIDS, 2020. “Global information and education on HIV and AIDS. HIV and AIDS in Lesotho”. Available:
[5] UNICEF & WORLD BANK, 2017. Lesotho: public health sector expenditure review. Washington D. C: World Bank Group. Available from:
[6] Ehrenkranz, P., Rosen, S., Boulle, A., Eaton, J., et al., 2021. “The revolving door of HIV care: Revising the service delivery cascade to achieve the UNAIDS 95-95-95 goals”. PLoS Med., 18(5):
[7] Huber, A., Pascoe, S., P., Nicchols, B., et al., 2021. “Differentiated Service Delivery Models for HIV Treatment in Malawi, South Africa, and Zambia: A Landscape Analysis”. Global Health: Science and Practice, 9(2), pp. 1-11.
[8] Ayala, G., Sprague, L., Merwe, L., et al., 2021. Peer- and community-led responses to HIV: A scoping review. PloS ONE Journal, 16(12), pp. 2-18.
[9] UNAIDS., 2019. “Global information and education on HIV and AIDS: HIV and AIDS in Lesotho”. Available from:
[10] Mavhu, W., Willis, N., Mufuka, J., et al., 2020 “Effect of a differentiated service delivery model on virological failure in adolescents with HIV in Zimbabwe (Zvandiri): A cluster-randomised controlled trial”. The Lancet Global Health, 8(2). Pp. 1-11.
[11] Pellecchia, U., Baert, S., Nundwe, S., et al., 2017. “We are part of a family”. Benefits and Limitations of the Community ART Groups (CAGs) in Thyolo, Malawi A Qualitative Study”. Journal of the international AIDS Society, 20(1), pp. 1-6.
[12] Decroo, T., Telfer, B., Dores, C. D., et al., 2017. “Effect of Community ART Groups on retention-in-care among patients on ART in Tete Province, Mozambique: a Cohort Study”. BJM Open, pp. 1-6.
[13] Bochner, A. F., Meacham, E. Mhungu, N., et al., 2019. “The rollout of Community ART Refill Groups in Zimbabwe: a qualitative evaluation”. Journal of the international AIDS Society. Hoboken: John Wiley and Sons Ltd, Vol. 22(8).
[14] Nyangu, I. and Nkosi, Z. Z., 2021. “Nurses’ Perceptions regarding the antiretroviral therapy services at selected health facilities in Lesotho”. American Journal of Nursing Science, 11(1), pp. 2-3.
[15] Kandasami, S., Shobiye, H. and Fakoya, A., et al., 2019. “Can Changes in Service Delivery Models Improve Program Quality and Efficiency? A Closer Look at HIV Programs in Kenya and Uganda.” J Acquir Immune Defic Syndr. 81(5), pp. 535-536.
[16] Miyingo, C., Mpayenda, T., Nyole, R., et al., 2023. HIV/AIDS - Research and Palliative Care. HIV Treatment and Care of Adolescents: Perspectives of Adolescents on Community-Based Models in Northern Uganda. Lira: Dove Medical Press Limited. pp. 105-112. Available at:
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  • APA Style

    Tsehloane, S. L., Nyangu, I. (2024). A Case Study on the Community ART Group Model of Care: Does It work for People Living with HIV and Healthcare Service Providers in Lesotho. American Journal of Nursing Science, 13(4), 77-85. https://doi.org/10.11648/j.ajns.20241304.12

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    ACS Style

    Tsehloane, S. L.; Nyangu, I. A Case Study on the Community ART Group Model of Care: Does It work for People Living with HIV and Healthcare Service Providers in Lesotho. Am. J. Nurs. Sci. 2024, 13(4), 77-85. doi: 10.11648/j.ajns.20241304.12

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    AMA Style

    Tsehloane SL, Nyangu I. A Case Study on the Community ART Group Model of Care: Does It work for People Living with HIV and Healthcare Service Providers in Lesotho. Am J Nurs Sci. 2024;13(4):77-85. doi: 10.11648/j.ajns.20241304.12

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  • @article{10.11648/j.ajns.20241304.12,
      author = {Setungoane Lucia Tsehloane and Isabel Nyangu},
      title = {A Case Study on the Community ART Group Model of Care: Does It work for People Living with HIV and Healthcare Service Providers in Lesotho
    },
      journal = {American Journal of Nursing Science},
      volume = {13},
      number = {4},
      pages = {77-85},
      doi = {10.11648/j.ajns.20241304.12},
      url = {https://doi.org/10.11648/j.ajns.20241304.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20241304.12},
      abstract = {The Community ART Group (CAG) model is a community-led model implemented to support people living with HIV to address barriers to HIV treatment continuity which remain a challenge in Lesotho. This study sought to explore the perspectives of people living with HIV and that of the healthcare service providers, regarding the CAG model in selected health facilities in Lesotho. An explorative descriptive qualitative study was conducted among purposively selected 20 people living with HIV and 8 healthcare service providers at 3 healthcare facilities. Qualitative data were collected through face-to-face in-depth interviews using semi-structured interview guides. All interviews were audio-recorded and transcribed verbatim. Thematic analysis was used following an inductive approach and sub-themes and themes were developed. The CAG model was relevant and acceptable to most of the respondents. They felt that it provided support to people living with HIV, promoted good adherence to treatment, improved treatment access, reduced transport costs, saved time, and reduced stigma. Good retention, favorable clinical outcomes and decongestion of health facilities were identified as key achievements linked to the CAG model. Age, proximity to the health facilities, readiness to disclose positive HIV status, availability of a variety of differentiated service delivery models, family support, and the level of trust emerged as factors affecting the acceptability of the model. Conflicts arising among members of the groups compromised service delivery quality and insufficient resources emerged as challenges. The results confirmed that the Community ART Group model can deliver intended peer-led support to People Living with HIV, resulting in the achievement of favorable clinical outcomes. It is therefore recommendable to consider investing in this community-led model for a sustained HIV response in the country.
    },
     year = {2024}
    }
    

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