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AIDS Behav. 2015 Oct;19(10):1801-17. doi: 10.1007/s10461-015-1054-6.

Behavioral intervention improves treatment outcomes among HIV-infected individuals who have delayed, declined, or discontinued antiretroviral therapy: a randomized controlled trial of a novel intervention.

Author information

1
Center for Drug Use and HIV Research (CDUHR), New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10010, USA. mg2890@nyu.edu.
2
Center for Drug Use and HIV Research (CDUHR), New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10010, USA. cmc13@nyu.edu.
3
Center for Drug Use and HIV Research (CDUHR), New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10010, USA. eaa6@nyu.edu.
4
Center for Drug Use and HIV Research (CDUHR), New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10010, USA. mjf223@nyu.edu.
5
Division of HIV/AIDS, Department of Medicine, University of California San Francisco (UCSF), San Francisco, CA, USA. monica.gandhi@ucsf.edu.
6
Department of Infectious Diseases, Peter Krueger Center for Immunological Disorders, Mount Sinai Beth Israel, New York, NY, USA. nsalomon@chpnet.org.
7
Center for Drug Use and HIV Research (CDUHR), New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10010, USA. adb12@nyu.edu.
8
Center for Drug Use and HIV Research (CDUHR), New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10010, USA. nrl4@nyu.edu.
9
School of Social Work, Columbia University, New York, NY, USA. mr108@columbia.edu.
10
Mount Sinai St. Luke's-Roosevelt Hospital Center, Spencer Cox Center for Health, New York, NY, USA. hannahlahozwolfe@gmail.com.
11
Center for Drug Use and HIV Research (CDUHR), New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10010, USA. isaiah.pickens@gmail.com.
12
Center for Drug Use and HIV Research (CDUHR), New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10010, USA. bolgerkelly9@gmail.com.
13
Center for Drug Use and HIV Research (CDUHR), New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10010, USA. dkbow@yahoo.com.
14
Department of Infectious Diseases, Mount Sinai Beth Israel, New York, NY, USA. perlman@chpnet.org.
15
Department of Infectious Diseases, Mount Sinai Beth Israel, New York, NY, USA. dmildvan@chpnet.org.

Abstract

Nationally up to 60 % of persons living with HIV are neither taking antiretroviral therapy (ART) nor well engaged in HIV care, mainly racial/ethnic minorities. This study examined a new culturally targeted multi-component intervention to address emotional, attitudinal, and social/structural barriers to ART initiation and HIV care. Participants (N = 95) were African American/Black and Latino adults with CD4 < 500 cells/mm(3) not taking ART, randomized 1:1 to intervention or control arms, the latter receiving treatment as usual. Primary endpoints were adherence, evaluated via ART concentrations in hair samples, and HIV viral load suppression. The intervention was feasible and acceptable. Eight months post-baseline, intervention participants tended to be more likely to evidence "good" (that is, 7 days/week) adherence (60 vs. 26.7 %; p = 0.087; OR = 3.95), and had lower viral load levels than controls (t(22) = 2.29, p = 0.032; OR = 5.20), both large effect sizes. This highly promising intervention merits further study.

KEYWORDS:

Antiretroviral therapy; Disparities; HIV/AIDS; Intervention; Motivational interviewing

PMID:
25835462
PMCID:
PMC4567451
DOI:
10.1007/s10461-015-1054-6
[Indexed for MEDLINE]
Free PMC Article

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