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AIDS Behav. 2020 Jan 13. doi: 10.1007/s10461-020-02785-6. [Epub ahead of print]

A Behavioral Adherence Intervention Improves Rates of Viral Suppression Among Adherence-Challenged People Living with HIV in South India.

Author information

1
Department of Medicine, Center for AIDS Prevention Studies, University of California, 550 16th Street, 3rd Floor, Box 0886, San Francisco, CA, 94143, USA. Maria.Ekstrand@ucsf.edu.
2
St John's Research Institute, St John's National Academy of Health Sciences, Bangalore, India. Maria.Ekstrand@ucsf.edu.
3
Department of Medicine, Center for AIDS Prevention Studies, University of California, 550 16th Street, 3rd Floor, Box 0886, San Francisco, CA, 94143, USA.
4
St John's Research Institute, St John's National Academy of Health Sciences, Bangalore, India.
5
St John's Medical College and Hospital, St John's National Academy of Health Sciences, Bangalore, India.
6
Karnataka State AIDS Prevention Society, Bangalore, India.

Abstract

The success of antiretroviral therapy (ART) has led to both extended life expectancy and improved quality of life among people living with HIV (PLWH). To maximize the efficacy of first line ART regimens in low- and middle-income countries (LMIC), we need culturally-relevant interventions that empower participants to reduce barriers to long-term uninterrupted adherence. The Chetana adherence intervention trial was designed in collaboration with local community groups as a comprehensive wellness program for adherence-challenged PLWH and included peer-led adherence support, yoga, nutrition, information about local resources, and individual counseling using motivational interviewing techniques. Intervention arm participants were almost twice as likely to be virally suppressed at their 12-month follow-up visit (AOR = 1.98; 95% CI [1.2, 3.23]) as were participants in the active control arm. They were also about twice as likely as control arm participants to self-report ≥ 95% adherence (AOR = 1.86, 95% CI [1.09, 3.15]), and as having eliminated individual adherence barriers (AOR = 2.33, 95% CI [1.51, 3.62]) and clinic attendance barriers (AOR = 2.01, 95% CI [1.20, 3.38]) These low-cost strategies can be implemented by local NGOs, making it both scalable and sustainable in this and similar settings.

KEYWORDS:

ART adherence trial; Cultural relevance; HIV; India; LMIC; PLWH; Viral suppression

PMID:
31933020
DOI:
10.1007/s10461-020-02785-6

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