{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:45:51Z","timestamp":1777927551781,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Malawi Defence Force (MDF) implemented test-and-start strategy in 2016 to expedite initiation of antiretroviral therapy (ART) for HIV diagnosed individuals. However, key indicators for the 95-95-95 targets, namely retention and viral load suppression, remained sub optimal. To address this, MDF introduced community-based peer navigators (PNs) in 2020 to support ART adherence. We sought to assess impact of this intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A mixed methods study was conducted where ART programmatic data was collected retrospectively from seven MDF health facilities. The analysis compared treatment interruption (ITT), return to treatment (RTT) and viral suppression rates 18\u00a0months before and after the intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median numbers IIT and RTT was 308 (IQR = 96) and 99 (IQR = 67) pre intervention respectively, while the median IIT and RTT was 145 (IQR = 47) and 160 (IQR = 46) post intervention respectively. Treatment current increased by 36.5% through back to care (BTC) and by 10.4% through new initiations. Out of 1,073 clients due for VL flagged on patient cards, 953 (88.9%) had their blood samples taken compared to 61.8% in pre intervention period (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The involvement of PNs led to notable improvements in program outcomes. Expanding the peer navigator model within the BTC initiative is recommended to sustain and build upon these gains.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09564624251356052","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T15:13:03Z","timestamp":1752073983000},"page":"916-922","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["An evaluation of using community-based peer navigators for improving HIV treatment outcomes among antiretroviral therapy clients in Malawi Defence Force clinics"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1519-260X","authenticated-orcid":false,"given":"AV","family":"Adson Nantchito","sequence":"first","affiliation":[{"name":"Military Health Service, Kamuzu Barracks Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Jimmy-Gama","sequence":"additional","affiliation":[{"name":"Freelance Researcher"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zimveka","family":"Chatsika","sequence":"additional","affiliation":[{"name":"Military Health Service, Kamuzu Barracks Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chifundo","family":"Azizi","sequence":"additional","affiliation":[{"name":"Military Health Service, Kamuzu Barracks Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yamikani","family":"Chinthuli","sequence":"additional","affiliation":[{"name":"Military Health Service, Kamuzu Barracks Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chester","family":"Makhuwira","sequence":"additional","affiliation":[{"name":"Military Health Service, Kamuzu Barracks Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gertrude","family":"Ngwata","sequence":"additional","affiliation":[{"name":"Military Health Service, Kamuzu Barracks Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kingsley","family":"Magomero","sequence":"additional","affiliation":[{"name":"Military Health Service, Kamuzu Barracks Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geofrey","family":"Ndekha","sequence":"additional","affiliation":[{"name":"Military Health Service, Kamuzu Barracks Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"e_1_3_7_2_2","volume-title":"Malawi population-based HIV impact assessment","author":"MPHIA","year":"2021","unstructured":"MPHIA. Malawi population-based HIV impact assessment. Lilongwe: Ministry of Health, 2021."},{"key":"e_1_3_7_3_2","unstructured":"UNAIDS. Malawi country fact sheet 2021. https:\/\/www.unaids.org\/en\/regionscountries\/countries\/malawi"},{"key":"e_1_3_7_4_2","volume-title":"Seroprevalence and behavioral epedimiological risk survey","author":"SABERS","year":"2018","unstructured":"SABERS. Seroprevalence and behavioral epedimiological risk survey. Lilongwe: Malawi Defence Force, 2018."},{"key":"e_1_3_7_5_2","first-page":"136","article-title":"Barriers and facilitators to patients adherence to antiretroviral treatment in Zambia:A qualitative study","author":"Sanjobo N","year":"2008","unstructured":"Sanjobo N, Frich J, Frethen A. Barriers and facilitators to patients adherence to antiretroviral treatment in Zambia:A qualitative study. Journal des Aspects Sociaux du VIH\/SIDA 2008; 136\u2013143.","journal-title":"Journal des Aspects Sociaux du VIH\/SIDA"},{"key":"e_1_3_7_6_2","volume-title":"Global HIV Statistics: In Ending the HIV Epidemic","author":"UNAIDS","year":"2020","unstructured":"UNAIDS. Global HIV Statistics: In Ending the HIV Epidemic. Geneva Switzerland: UNAIDS, 2020. Retrieved from UNAIDS 2020: 28 March 2020. https:\/\/www.unaids.org\/en\/resources\/fact-sheet (Accessed 28 March 2021)."},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-54229-z"},{"issue":"1","key":"e_1_3_7_8_2","first-page":"852489","article-title":"Factors determining survival and retention among HIV-infected children and adolescents in a community","volume":"2014","author":"Massavon W-M","year":"2014","unstructured":"Massavon W-M, Mugenyi L, McFarland W, et al. Factors determining survival and retention among HIV-infected children and adolescents in a community. 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J Int Assoc Phys AIDS Care 2020; 19: 1\u20138.","journal-title":"J Int Assoc Phys AIDS Care"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000003453"},{"key":"e_1_3_7_16_2","unstructured":"UNAIDS. 2019. https:\/\/www.unaids.org\/en\/regionscountries\/countries\/malawi"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1999-8"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-07439-4"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-016-1190-y"},{"issue":"8","key":"e_1_3_7_20_2","first-page":"e25774","article-title":"Impact of SMS and peer navigation on retention in HIV care among adults in South Africa: results of a three-arm cluster randomised controlled trial","volume":"24","author":"Stewart W","year":"2021","unstructured":"Stewart W, Agnew E, de Kadt J, et al. 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