Sarah Pollock1, Forrest Toegel2, August F Holtyn3, Andrew M Rodewald4, Jeannie-Marie Leoutsakos5, Michael Fingerhood6, Kenneth Silverman7. 1. Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue Suite 350 East, Baltimore, MD, 21224, USA. Electronic address: spolloc6@jhu.edu. 2. Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue Suite 350 East, Baltimore, MD, 21224, USA. Electronic address: ftoegel1@jhmi.edu. 3. Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue Suite 350 East, Baltimore, MD, 21224, USA. Electronic address: aholtyn1@jhmi.edu. 4. Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue Suite 350 East, Baltimore, MD, 21224, USA. Electronic address: arodewa1@jhmi.edu. 5. Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue Suite 350 East, Baltimore, MD, 21224, USA. Electronic address: jeannie-marie@jhu.edu. 6. Department of Medicine, Comprehensive Care Practice, Johns Hopkins Bayview Medical Center, 5200 Eastern Ave # W2, Baltimore, MD 21224, USA. Electronic address: mifinger@jhmi.edu. 7. Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue Suite 350 East, Baltimore, MD, 21224, USA. Electronic address: ksilverm@jhmi.edu.
Abstract
BACKGROUND:Antiretroviral therapy (ART) adherence is essential to maintenance of undetectable viral loads among people living with HIV, which improves health and reduces HIV transmission. Despite these benefits, some people living with HIV do not maintain the level of adherence required to sustain an undetectable viral load. This problem is particularly common among people who use drugs. OBJECTIVE: To determine effects of incentivizing viral suppression in people living with HIV who used cocaine or opiates. METHODS: In this secondary analysis of data collected during a randomized controlled trial, participants (N=102) with detectable HIV viral loads (>200 copies/mL) were randomly assigned to a Usual Care or Incentive group. Usual Care participants did not earn incentives for viral suppression. Incentive participants earned incentives ($10/day maximum) for providing blood samples with reduced or undetectable (<200 copies/mL) viral loads. All participants completed assessments every three months. Results collected during the first year were compared based on group assignment and drug use. RESULTS: Among participants who used cocaine or opiates, Incentive participants (n = 27) provided more (OR:4.0, CI:1.6-10.3, p = .004) blood samples with an undetectable viral load (69 %) than Usual Care participants (n = 25; 41 %). Among participants who did not use cocaine or opiates, Incentive participants (n = 25) provided more (OR:4.1, CI:1.5-10.7, p = .005) blood samples with an undetectable viral load (78 %) than Usual Care participants (n = 25; 36 %). Effects of incentives did not differ by drug use (OR:1.0, CI:0.3-4.0, p = .992). CONCLUSIONS: Incentivizing viral suppression can promote undetectable viral loads in people living with HIV who use cocaine or opiates.
RCT Entities:
BACKGROUND: Antiretroviral therapy (ART) adherence is essential to maintenance of undetectable viral loads among people living with HIV, which improves health and reduces HIV transmission. Despite these benefits, some people living with HIV do not maintain the level of adherence required to sustain an undetectable viral load. This problem is particularly common among people who use drugs. OBJECTIVE: To determine effects of incentivizing viral suppression in people living with HIV who used cocaine or opiates. METHODS: In this secondary analysis of data collected during a randomized controlled trial, participants (N=102) with detectable HIV viral loads (>200 copies/mL) were randomly assigned to a Usual Care or Incentive group. Usual Care participants did not earn incentives for viral suppression. Incentive participants earned incentives ($10/day maximum) for providing blood samples with reduced or undetectable (<200 copies/mL) viral loads. All participants completed assessments every three months. Results collected during the first year were compared based on group assignment and drug use. RESULTS: Among participants who used cocaine or opiates, Incentive participants (n = 27) provided more (OR:4.0, CI:1.6-10.3, p = .004) blood samples with an undetectable viral load (69 %) than Usual Care participants (n = 25; 41 %). Among participants who did not use cocaine or opiates, Incentive participants (n = 25) provided more (OR:4.1, CI:1.5-10.7, p = .005) blood samples with an undetectable viral load (78 %) than Usual Care participants (n = 25; 36 %). Effects of incentives did not differ by drug use (OR:1.0, CI:0.3-4.0, p = .992). CONCLUSIONS: Incentivizing viral suppression can promote undetectable viral loads in people living with HIV who use cocaine or opiates.
Authors: Julio S G Montaner; Evan Wood; Thomas Kerr; Viviane Lima; Rolando Barrios; Kate Shannon; Richard Harrigan; Robert Hogg Journal: J Acquir Immune Defic Syndr Date: 2010-12 Impact factor: 3.731
Authors: Charles H Hinkin; Terry R Barclay; Steven A Castellon; Andrew J Levine; Ramani S Durvasula; Sarah D Marion; Hector F Myers; Douglas Longshore Journal: AIDS Behav Date: 2007-03
Authors: Lawrence Mbuagbaw; Bhairavi Sivaramalingam; Tamara Navarro; Nicholas Hobson; Arun Keepanasseril; Nancy J Wilczynski; R Brian Haynes Journal: AIDS Patient Care STDS Date: 2015-03-31 Impact factor: 5.078
Authors: Mark A Marzinke; Autumn Breaud; Teresa L Parsons; Myron S Cohen; Estelle Piwowar-Manning; Susan H Eshleman; William Clarke Journal: Clin Chim Acta Date: 2014-03-22 Impact factor: 3.786
Authors: Danielle R Davis; Allison N Kurti; Joan M Skelly; Ryan Redner; Thomas J White; Stephen T Higgins Journal: Prev Med Date: 2016-08-08 Impact factor: 4.018
Authors: Steve Kanters; Jay J H Park; Keith Chan; Maria Eugenia Socias; Nathan Ford; Jamie I Forrest; Kristian Thorlund; Jean B Nachega; Edward J Mills Journal: Lancet HIV Date: 2016-11-16 Impact factor: 12.767