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Increasing Quality of Life and Reducing HIV Burden: The PATH+ Intervention

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Abstract

The heightened risk of persons with serious mental illness (SMI) to contract and transmit human immunodeficiency virus (HIV) is a public health problem. Our objective was test the effectiveness of a community-based advanced practice nurse intervention to promote adherence to HIV and psychiatric treatment regimens call Preventing AIDS Through Health for Positives (PATH+). We enrolled 238 HIV-positive subjects with SMI who were in treatment at community HIV provider agencies from 2004 to 2009. Participants in the intervention group were assigned an advanced practice nurse who provided community-based care management at a minimum of one visit/week and coordinated their medical and mental healthcare for 12 months. A parallel process latent growth curve model using three data points for biomarkers (baseline, 12 and 24 months) and five data points for health related quality of life (baseline, 3, 6, 12, and 24 months) showed moderate to excellent fit for modeling changes in CD4, viral load, and mental and physical SF-12 subscales. Results suggest that positive effects for PATH+ persisted at 24 months; 12 months after the intervention ended. This project demonstrates the effectiveness of a nurse-led, community-based, individually tailored adherence intervention. We demonstrated improved outcomes in individuals with HIV/SMI and regarding health-related quality of life and reductions in disease burden.

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Acknowledgments

This research was supported by grants from National Institute on Drug Abuse (RO1-DA-015627 ‘‘HIV Prevention Program among Substance Abusing SMI”), the National Institute for Nursing Research (RO1-NR-008851 ‘‘Nursing Intervention for HIV Regimen Adherence among SMI’’, the Penn Center for AIDS Research (P30AI045008), and the Penn Mental Health AIDS Research Center (P30MH097488)). Trial registration: clinicaltrials.gov identifier NCT00264823. The authors would like to thank William W. Thompson., Ph.D. of the Health-Related Quality of Life and Well-Being Team, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention for his helpful comments.

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Authors and Affiliations

  1. Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Philadelphia, PA, 19104-3309, USA

    Michael B. Blank

  2. Annenberg Public Policy Center, University of Pennsylvania, 202 South 36th Street, Philadelphia, PA, 19104-2648, USA

    Michael B. Blank & Michael Hennessy

  3. HIV/AIDS Prevention Research Division, University of Pennsylvania, 3535 Market St., Philadelphia, PA, 19104-3309, USA

    Marlene M. Eisenberg

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  1. Michael B. Blank
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  2. Michael Hennessy
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  3. Marlene M. Eisenberg
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Correspondence to Michael B. Blank.

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Blank, M.B., Hennessy, M. & Eisenberg, M.M. Increasing Quality of Life and Reducing HIV Burden: The PATH+ Intervention. AIDS Behav 18, 716–725 (2014). https://doi.org/10.1007/s10461-013-0606-x

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  • DOI: https://doi.org/10.1007/s10461-013-0606-x

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