OBJECTIVE: To evaluate the efficacy of a program designed to improve adherence to antiretroviral therapy among patients with poor adherence. METHODS: A randomized intervention trial was conducted among 90 HIV-positive patients experiencing treatment failure as a result of noncompliance with their medication regimen. Eligible participants were randomly assigned to an adherence case management intervention with monetary reinforcement (CM) or to a standard of care group (SC). The CM participants met regularly with a treatment advocate for individualized adherence support. Efficacy was measured in terms of reductions in viral load and improvements in immune function at weeks 12, 24, and 48. RESULTS: After 48 weeks, 55% (n=26) of those in the CM achieved at least a 1-log10 drop in viral load as compared to 28% (n=12) in the SC group (P=.0089). Furthermore, the mean CD4 count was 209 cells/mm3 for the CM group as compared to 150 cells/mm3 in the SC group (P=.0333). Based on logistic regression analysis, being in the CM was an independent predictor of reduction in viral load (odds ratio=2.49; P=.0514). CONCLUSION: The individualized adherence intervention is feasible and effective in reducing viral load and improving immune function.
RCT Entities:
OBJECTIVE: To evaluate the efficacy of a program designed to improve adherence to antiretroviral therapy among patients with poor adherence. METHODS: A randomized intervention trial was conducted among 90 HIV-positivepatients experiencing treatment failure as a result of noncompliance with their medication regimen. Eligible participants were randomly assigned to an adherence case management intervention with monetary reinforcement (CM) or to a standard of care group (SC). The CM participants met regularly with a treatment advocate for individualized adherence support. Efficacy was measured in terms of reductions in viral load and improvements in immune function at weeks 12, 24, and 48. RESULTS: After 48 weeks, 55% (n=26) of those in the CM achieved at least a 1-log10 drop in viral load as compared to 28% (n=12) in the SC group (P=.0089). Furthermore, the mean CD4 count was 209 cells/mm3 for the CM group as compared to 150 cells/mm3 in the SC group (P=.0333). Based on logistic regression analysis, being in the CM was an independent predictor of reduction in viral load (odds ratio=2.49; P=.0514). CONCLUSION: The individualized adherence intervention is feasible and effective in reducing viral load and improving immune function.
Authors: Maxine L Stitzer; Alexis S Hammond; Tim Matheson; James L Sorensen; Daniel J Feaster; Rui Duan; Lauren Gooden; Carlos Del Rio; Lisa R Metsch Journal: AIDS Patient Care STDS Date: 2018-06-08 Impact factor: 5.078
Authors: Sonjia Kenya; Natasha Chida; Gabriel Cardenas; Margaret Pereyra; Carlos Del Rio; Allan Rodriguez; Lisa Metsch Journal: J HIV AIDS Soc Serv Date: 2014
Authors: Mahnaz R Charania; Khiya J Marshall; Cynthia M Lyles; Nicole Crepaz; Linda S Kay; Linda J Koenig; Paul J Weidle; David W Purcell Journal: AIDS Behav Date: 2014-04
Authors: Antoine D Brantley; Samuel Burgess; Jacquelyn Bickham; Deborah Wendell; DeAnn Gruber Journal: Public Health Rep Date: 2018 Nov/Dec Impact factor: 2.792