Comparative Effectiveness of a Multi-Arm Health Education Intervention on Adherence Behaviour and Health Outcomes Among PLWHIV in Taraba State, Nigeria

Human Immunodeficiency Virus (HIV) continues to constitute a significant public health challenge, particularly in sub-Saharan Africa, where optimal adherence to antiretroviral therapy (ART) is essential for achieving favourable treatment outcomes. Given the paucity of comparative evidence on the effectiveness of health education strategies in improving adherence behaviour and health outcomes among people living with HIV (PLWHIV) in resource-constrained settings, this study compared four health education interventions among 60 PLWHIV in Nigeria. Data were collected using validated questionnaires and analysed using descriptive statistics and one-way analysis of variance (ANOVA) at a 0.05 level of significance. The combined intervention produced the greatest improvements: treatment behaviour increased in mean score from 7.67 to 16.27, medication adherence from 3.20 to 8.33, pill count from 66.16% to 98.98%, and appointment-keeping from 4.47 to 7.93 (all p = 0.00), indicating very large effects. Researcher-led intervention showed moderate significant gains (adherence: 2.24–3.17; pill count: 59.99%–97.99%), while peer-led intervention achieved smaller significant improvements (adherence: 2.76–3.36, p = 0.049; pill count: 61.00%–90.01%). Control changes were minimal and largely non-significant. The interventions demonstrated a hierarchical pattern of effectiveness, with the combined peer-led and researcher-led health education approach yielding the greatest impact, followed by researcher-led health education, peer-led health education, and the control condition, respectively. Factorial-based combined peer- and researcher-led health education significantly improves ART adherence and clinical outcomes; scale up integrated, theory-driven HIV interventions.