AN ADHERENCE INTERVENTION FOR ANTIRETROVIRAL REGIMENS

Emory University, Atlanta GA

Investigators

Linked publications & trials

Abstract

DESCRIPTION (Adapted from Applicant's Abstract): The introduction of antiretroviral medications, in particular protease inhibitors, into the clinical care of persons with HIV disease has resulted in dramatic declines in morbidity and mortality. Paradoxically, these same medications, taken incorrectly, can engender resistance and compromise successful treatment. The purpose of the proposed study is to test an intervention to promote adherence. The research design for this study will be an experimental design in which HIV infected participants will be randomly assigned to one of two conditions: a Usual Care Condition and a Usual Care Plus Motivational Interviewing Treatment Condition. To participate, individuals must meet the following criteria: 1) infected with HIV; 2) referred to the nurse-educator for assessment and adherence education; 3) taking at least on nucleoside and one protease inhibitor; 4) 18 years of age and older; 5) English speaking; 6)have a telephone and VCR (or access to one); 7) mentally competent as determined by a screening assessment; and 8) willing to participate. Individuals will first complete a screening assessment for eligibility; if eligible, they will complete a baseline assessment and will then be randomly assigned to the Usual Care or Motivational Interviewing Treatment Conditions augmented with self-help materials. The Usual Care Condition consists of the usual adherence education and support provided by the Grady Health Systems Infectious Disease Program (IDP). The Motivational Interviewing Treatment Condition consists of the usual adherence education and support plus a theory-based intervention aimed at enhancing medication adherence. The Motivational Interviewing intervention will consists of one in-person introductory session and four telephone-based motivational interviewing sessions conducted over 12 weeks, written self-help materials, and a self-help videotape. Follow-up assessments for all participants will be completed at 3, 6 and 12 months. The total time to recruit participants and conduct the interventions is expected to be 27 months (following a one year development phase). Each participant will be followed for 12 months. With the effects of attrition incorporated into the sample size calculations, a total of 240 participants or 120 per condition will be required to test the primary hypotheses.