Association of integrated psychosocial support with retention in care and viral suppression among women living with HIV in the Central African Republic: a retrospective cohort study
Abstract
Background: Mental health disorders, stigma, and social vulnerability may negatively influence treatment adherence and retention in care among women living with HIV (WLHIV). Evidence on psychosocial support interventions in fragile settings such as the Central African Republic remains limited. This study assessed the association between integrated psychosocial support and HIV treatment outcomes among WLHIV receiving antiretroviral therapy (ART) in Bangui.
Methods: We conducted a retrospective cohort study using routinely collected medical records from two HIV treatment centres in Bangui. Women aged ≥ 15 years who initiated ART between 1 January and 31 December 2022 were included and followed for 24 months. One centre provided an integrated psychosocial support programme in addition to routine HIV care, whereas the other provided standard care. Data were retrospectively collected between 1 March and 31 May 2025 from paper medical records and the SANTIA electronic database. Outcomes included retention in care, attrition, and viral suppression (< 40 copies/mL) at 24 months. Kaplan-Meier methods and Cox proportional hazards models were used to assess factors associated with attrition.
Results: A total of 598 women were included, including 314 receiving psychosocial support and 284 receiving standard care. Attrition during follow-up was lower among women receiving psychosocial support than among those receiving standard care (21.0% vs. 39.1%). Retention probability at 24 months was higher in the psychosocial support group (79% vs. 61%; log-rank p < 0.001). Viral suppression at 24 months was also higher among women receiving psychosocial support (78.6% vs. 69.4%; p = 0.031). In multivariable analysis, psychosocial support was associated with a lower risk of attrition (aHR = 0.44, 95% CI: 0.31–0.61 ; p < 0.001), while disclosure of HIV status to a partner was also associated with lower attrition (aHR = 0.69, 95% CI: 0.49–0.96 ; p = 0.031).
Conclusions: Among WLHIV in Bangui, care in a facility offering integrated psychosocial support was associated with higher retention in care, lower attrition, and higher viral suppression over 24 months. Given the observational design and facility-level definition of exposure, these findings should be interpreted as associations rather than evidence of causality. Further prospective studies are warranted to evaluate the contribution of specific psychosocial support components to HIV treatment outcomes.
Related
- Youths’ satisfaction with youth-friendly services and its relationship with retention in HIV care and viral load suppression at a tertiary hospital in Enugu State: a retrospective cross-sectional study with retrospective record review
- Sustained Viral Suppression and its association with Psychiatric Morbidity and Sleep Quality among Older Adults with Human Immunodeficiency Virus: Evidence from a Retrospective Cohort in Ibadan, Nigeria.
- Association of “Ippatsu-Gei,” a Brief Psychosocial Interaction, with Spontaneous Activity and Adverse Events in Home-Visit Dysphagia Rehabilitation: A Retrospective Cohort Study
- Association of healthcare access, demographic and psychosocial factors with herbal medicine use: a survey of paediatric and adult outpatients
- A retrospective mixed methods analysis of maternal psychosocial health during the COVID-19 pandemic in Ghana: lessons for future public health crises
BibTeX
@article{ngouyombo2026association,
title = {{Association of integrated psychosocial support with retention in care and viral suppression among women living with HIV in the Central African Republic: a retrospective cohort study}},
author = {Ange Donatien Ngouyombo and Christelle Corinne Folefack Tatsado Ngouyombo and Christelle Gina Niamathé Lemotomo and Rodrigue Herman Doyama-woza and Sylvain Honoré Woromogo and Jean de Dieu Longo},
journal = {BMC Public Health},
year = {2026},
month = oct,
doi = {10.1186/s12889-026-29755-2},
url = {https://link.springer.com/10.1186/s12889-026-29755-2},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association of integrated psychosocial support with retention in care and viral suppression among women living with HIV in the Central African Republic: a retrospective cohort study
AU - Ange Donatien Ngouyombo
AU - Christelle Corinne Folefack Tatsado Ngouyombo
AU - Christelle Gina Niamathé Lemotomo
AU - Rodrigue Herman Doyama-woza
AU - Sylvain Honoré Woromogo
AU - Jean de Dieu Longo
PY - 2026
DA - 2026/10/01
JO - BMC Public Health
DO - 10.1186/s12889-026-29755-2
UR - https://link.springer.com/10.1186/s12889-026-29755-2
AB - Background: Mental health disorders, stigma, and social vulnerability may negatively influence treatment adherence and retention in care among women living with HIV (WLHIV). Evidence on psychosocial support interventions in fragile settings such as the Central African Republic remains limited. This study assessed the association between integrated psychosocial support and HIV treatment outcomes among WLHIV receiving antiretroviral therapy (ART) in Bangui. Methods: We conducted a retrospective cohort study using routinely collected medical records from two HIV treatment centres in Bangui. Women aged ≥ 15 years who initiated ART between 1 January and 31 December 2022 were included and followed for 24 months. One centre provided an integrated psychosocial support programme in addition to routine HIV care, whereas the other provided standard care. Data were retrospectively collected between 1 March and 31 May 2025 from paper medical records and the SANTIA electronic database. Outcomes included retention in care, attrition, and viral suppression (< 40 copies/mL) at 24 months. Kaplan-Meier methods and Cox proportional hazards models were used to assess factors associated with attrition. Results: A total of 598 women were included, including 314 receiving psychosocial support and 284 receiving standard care. Attrition during follow-up was lower among women receiving psychosocial support than among those receiving standard care (21.0% vs. 39.1%). Retention probability at 24 months was higher in the psychosocial support group (79% vs. 61%; log-rank p < 0.001). Viral suppression at 24 months was also higher among women receiving psychosocial support (78.6% vs. 69.4%; p = 0.031). In multivariable analysis, psychosocial support was associated with a lower risk of attrition (aHR = 0.44, 95% CI: 0.31–0.61 ; p < 0.001), while disclosure of HIV status to a partner was also associated with lower attrition (aHR = 0.69, 95% CI: 0.49–0.96 ; p = 0.031). Conclusions: Among WLHIV in Bangui, care in a facility offering integrated psychosocial support was associated with higher retention in care, lower attrition, and higher viral suppression over 24 months. Given the observational design and facility-level definition of exposure, these findings should be interpreted as associations rather than evidence of causality. Further prospective studies are warranted to evaluate the contribution of specific psychosocial support components to HIV treatment outcomes.
SN - 1471-2458
ER -