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

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

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Anti-Retroviral Agents / therapeutic use*
  • Behavior Therapy*
  • Black or African American / psychology*
  • CD4 Lymphocyte Count
  • Continuity of Patient Care
  • Female
  • Follow-Up Studies
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • Healthcare Disparities
  • Hispanic or Latino / psychology*
  • Humans
  • Male
  • Middle Aged
  • Motivational Interviewing*
  • Patient Acceptance of Health Care / ethnology
  • Patient Acceptance of Health Care / psychology
  • Patient Compliance* / ethnology
  • Patient Compliance* / psychology
  • Treatment Outcome
  • Viral Load

Substances

  • Anti-Retroviral Agents