Skip to main content

Advertisement

SpringerLink
Log in

Optimizing ART Adherence: Update for HIV Treatment and Prevention

  • Behavioral-Bio-Medical Interface (JL Brown and RJ DiClemente, Section Editors)
  • Published:
Current HIV/AIDS Reports Aims and scope Submit manuscript

Abstract

Optimal adherence to antiretroviral therapy (ART) is central to achieving viral suppression and positive health outcomes in HIV-infected individuals. Virally suppressed individuals can also reduce the risk of HIV transmission to uninfected partners. Hence, adherence to ART has become both an HIV treatment and an HIV prevention strategy. However, achieving optimal ART adherence can be challenging, especially over the long term. It is increasingly important for clinicians and researchers to be abreast of the most recent developments in the field as new biomedical approaches to treatment emerge and as guidelines for the use of pre-exposure prophylaxis (PrEP) are disseminated to providers serving HIV affected populations. Several reviews have described numerous ART adherence interventions that have been developed and/or tested with the most recent review including literature up to 2012. To augment the literature, we present a review of ART adherence interventions from 2013 to the present. We included peer-reviewed journals as well as abstracts from two key conferences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Meichenbaum D, Turk DC. Facilitating treatment adherence: a practitioner’s guidebook. The University of Michigan: Plenum Press; 1987. 310 p.

    Book  Google Scholar 

  2. Hertogs K, Bloor S, Vroey VD, Eynde CD, Dehertogh P, Cauwenberge A, et al. A novel human immunodeficiency virus type 1 reverse transcriptase mutational pattern confers phenotypic lamivudine resistance in the absence of mutation 184V. Antimicrobial Agents Chemotherapy. 2000;44(3):568–73.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Hogg RS, Heath K, Bangsberg D, Yip B, Press N, O’Shaughnessy MV, et al. Intermittent use of triple-combination therapy is predictive of mortality at baseline and after 1 year of follow-up. AIDS. 2002;17(7):1051–8.

    Article  Google Scholar 

  4. Kozal MJ, Rivet AK, Chiarella J, Schreibman T, Cornman D, Fisher W, et al. Antiretroviral resistance and high-risk transmission behavior among HIV-positive patients in clinical care. AIDS. 2004;18(16):2185–9.

    Article  PubMed  Google Scholar 

  5. Mannheimer S, Friedland G, Matts J, Child C, Chesney M. The consistency of adherence to antiretroviral therapy predicts biologic outcomes for human immunodeficiency virus-infected persons in clinical trials. Clin Infect Dis. 2002;34(8):1115–21.

    Article  PubMed  Google Scholar 

  6. McNabb J, Ross JW, Abriola K, Turley C, Nightingale CH, Nicolau DP. Adherence to highly active antiretroviral therapy predicts virologic outcome at an inner-city human immunodeficiency virus clinic. Clin Infect Dis. 2001;33(5):700–5.

    Article  CAS  PubMed  Google Scholar 

  7. Wood E, Hogg RS, Yip B, Harrigan PR, O’Shaughnessy MV, Montaner JS. Effect of medication adherence on survival of HIV infected adults who start highly active antiretroviral therapy when the CD4? cell count is 0.200 to 0.350 9 10(9) cells/L. Ann Intern Med. 2003;139:810–6.

    Article  PubMed  Google Scholar 

  8. Pasternak AO, de Bruin M, Jurriaans S, Bakker M, Berkhout B, Prins JM, et al. (2012) Modest nonadherence to antiretroviral therapy promotes residual HIV-1 replication in the absence of virological rebound in plasma. J Infect Dis 210(3)

  9. Cohen MS, McCauley M, Gamble TR. HIV treatment as prevention and HPTN 052. Curr Opin HIV AIDS. 2012;7(2):99–105.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009;373:48–57.

    Article  PubMed  Google Scholar 

  11. Walensky RP, Paltiel AD, Losina E, Morris BL, Scott CA, Rhode ER, et al. Test and treat DC: forecasting the impact of a comprehensive HIV strategy in Washington DC. Clin Infect Dis. 2010;51(4):392–400.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Centers for Disease Control. Vital signs: HIV prevention through care and treatment. MMWR CDC Surveillance Summary. 2011;60(47):1618–23.

    Google Scholar 

  13. Gardner EM, McLees MP, Steiner JF, del Rio C, Burman WJ. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011;52(6):793–800.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Centers for Disease Control and Prevention. Linkage to and retention in HIV medical care 2013 [July 20, 2014]. Available from: http://www.cdc.gov/hiv/prevention/programs/pwp/linkage.html

  15. Kashuba AD, Dyer JR, Kramer LM, Raasch RH, Eron JJ, Cohen MS. Antiretroviral-drug concentrations in semen: implications for sexual transmission of human immunodeficiency virus type 1. Antimicrob Agents Chemother. 1999;43:1817–26.

    CAS  PubMed Central  PubMed  Google Scholar 

  16. Karim QA, Karim SSA, Frohlich JA, Grobler AC, Baxter C, Mansoor LE, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329(5996):1168–74.

    Article  Google Scholar 

  17. Grant RM. Antiretroviral agents used by HIV-uninfected persons for prevention: pre- and postexposure prophylaxis. Clin Infect Dis. 2010;50(Supplement 3):S96–S101.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367:399–410.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Nicol MR, Adams JL, Kashuba ADM (2013) HIV PrEP trials: the road to success. Clin Investig 3(3)

  20. Boffito M, Jackson A, Asboe D. Pharmacology lessons from chemoprophylaxis studies. Clin Infect Dis. 2014;59(supplement 1):S52–S4.

    Article  PubMed  Google Scholar 

  21. Wolf MS, Davis TC, Osborn CY, Skripkauskasa S, Bennett CL, Makoul G. Literacy, self-efficacy, and HIV medication adherence. Patient Educ Couns. 2007;65(2):253–60.

    Article  PubMed  Google Scholar 

  22. Lucas GM. Substance abuse, adherence with antiretroviral therapy, and clinical outcomes among HIV-infected individuals. Life Sci. 2011;88(21–22):948–52.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Pence BW. The impact of mental health and traumatic life experiences on antiretroviral treatment outcomes for people living with HIV/AIDS. J Antimicrob Chemother. 2009;63(4):636–40.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Weiser SD, Frongillo EA, Ragland K, Hogg RS, Riley ED, Bangsberg DR. Food insecurity is associated with incomplete HIV RNA suppression among homeless and marginally housed HIV-infected individuals in San Francisco. J Gen Intern Med. 2009;24(1):14–20.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Rintamaki LS, Davis TC, Skripkauskas S, Bennett CL, Wolf MS. Social stigma concerns and HIV medication adherence. AIDS Patient Care STDs. 2006;20(5):359–68.

    Article  PubMed  Google Scholar 

  26. Tuller DM, Bangsberg D, Senkungu J, Ware NC, Emenyonu N, Weiser SD. Transportation costs impede sustained adherence and access to HAART in a clinic population in southwestern Uganda: a qualitative study. AIDS Behav. 2010;14(4):778–84.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Golin CE, Liu H, Hays RD, Miller LG, Beck CK, Ickovics J, et al. A prospective study of predictors of adherence to combination antiretroviral medication. J Gen Intern Med. 2002;17(10):756–65.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Simoni JM, Pearson CR, Pantalone DW, Marks G, Crepaz N. Efficacy of interventions in improving highly active antiretroviral therapy adherence and HIV-1 RNA viral load. A meta-analytic review of randomized controlled trials. JAIDS J Acquir Immune Defic Syndr. 2006;43(Supplement 1):S23–35.

    Article  Google Scholar 

  29. Amico KR, Harman J, Johnson BT. Efficacy of antiretroviral therapy adherence interventions: a research synthesis of trials, 1996 to 2004. JAIDS J Acquir Immune Defic Syndr. 2006;41(3):285–97.

    Article  Google Scholar 

  30. Chaiyachati KH, Ogbuoji O, Price M, Suthar AB, Negussie EK, Bärnighausen T (2014) Interventions to improve adherence to antiretroviral therapy: a rapid systematic review. AIDS Suppl 2:S187-204

  31. Thompson MA, Mugavero MJ, Amico KR, Cargill VA, Chang LW, Gross R, et al. Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an international association of physicians in AIDS care panel. Ann Intern Med. 2012;256:817–33.

    Article  Google Scholar 

  32. Belzer ME, Naar-King S, Olson J, Sarr M, Thornton S, Kahana SY, et al (2013) The use of cell phone support for non-adherent HIV-infected youth and young adults: an initial randomized and controlled intervention trial. AIDS Behav

  33. Castro JG, Waldrop-Valverde D, Valverde EE (2013) An educational intervention with Hispanic HIV infected patients: a randomized study. Epidemiol 4(1).

  34. Robbins GK, Testa MA, Su M, Safren SA, Morse G, Lammert S, et al. Site nurse-initiated adherence and symptom support telephone calls for HIV-positive individuals starting antiretroviral therapy, ACTG 5031: substudy of ACTG 384. HIV Clinical Trials. 2013;14(5):235–53.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Kalichman S, Cherry C, Kalichman MO, Amaral C, White D, Cruess D, et al. Randomized clinical trial of HIV treatment adherence counseling interventions for people living with HIV and limited health literacy. JAIDS J Acquir Immune Defic Syndr. 2013;63(1):42–50.

    Article  CAS  Google Scholar 

  36. Lewis MA, Uhrig JD, Bann CM, Harris JL, Furberg RD, Coomes C, et al. Tailored text messaging intervention for HIV adherence: a proof-of-concept study. Health Psychol. 2013;32(3):248–53.

    Article  PubMed  Google Scholar 

  37. Claborn KR, Leffingwell TR, Miller MB, Ellen Meier E, Stephens JR. Pilot study examining the efficacy of an electronic intervention to promote HIV medication adherence. AIDS Care. 2014;26(3):404–9.

    Article  PubMed  Google Scholar 

  38. Letourneau EJ, Ellis DA, Naar-King S, Chapman JE, Cunningham PB, Fowler S. Multisystemic therapy for poorly adherent youth with HIV: results from a pilot randomized controlled trial. AIDS Care. 2013;25(4):507–14.

    Article  PubMed  Google Scholar 

  39. Reznick OG, McCartney K, Gregorich SE, Zack B, Feaster DJ. An ecosystem-based intervention to reduce HIV transmission risk and increase medication adherence among inmates being released to the community. J Correct Health Care. 2013;19(3):178–93.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Robbins RN, Mellins CA, Leu C, Rowe J, Warne P, Abrams E, et al. (2014) Enhancing lay counselor capacity to improve patient outcomes with multimedia technology. AIDS Behav. Forthcoming 2015.

  41. Bhana A, Mellins CA, Petersen I, Alicea S, Myeza N, Holst H, et al. The VUKA family program: piloting a family-based psychosocial intervention to promote health and mental health among HIV infected early adolescents in South Africa. AIDS Care. 2014;26(1):1–11.

    Article  PubMed  Google Scholar 

  42. Jones D, Bofil L, Aristegui I, Mattioli I, Ceccini D, Sued O, et al. (eds) (2014) COPA: Enhancing adherence, engagement, and retention in HIV Care in Argentina. 9th International Conference on HIV treatment and Prevention Adherence. Miami, Fl.

  43. Enriquez M, Hart K (eds) (2014) "Someone to Listen": Becoming adherent to HIV medication after repeated failure. 9th International Conference on HIV Treatment and Prevention Adherence. Miami, Fl.

  44. van der Straten A, Mayo A, Brown E, Amico KR, Cheng H, Laborde N, et al. (eds) (2014) Assessment of VOICE adherence support program (VASP) in the MTN-003 Trial. 9th International Conference on HIV treatment and Prevention Adherence. Miami, Fl.

  45. Rana A, van den Berg J, Lamy E, Beckwith CG (eds) (2014) Piloting an mHealth intervention to improve treatment adherence among newly diagnosed and non-adherent HIV positive patients. 9th International Conference on HIV treatment and Prevention Adherence. Miami, Fl.

  46. Ingersoll K, Dillingham R, Reynolds G, Freeman J, Hosseinbor A, Hettema J (eds) (2014) Feasibility and impact of a personalized bidirectional text messaging ART adherence tool for nonurban substance users. 9th International Conference on HIV treatment and Prevention Adherence. Miami, Fl.

  47. Dennis D, Abrams L, Morey T, Melker R (eds) (2014) Usability evaluation of SMART adherence system in HIV-positive patients. 9th International Conference on HIV treatment and Prevention Adherence. Miami, Fl.

  48. Schneider MP, Rotzinger A, Maestralli D, Bugnon O, Cavassini M, Parienti JJ. Adherence-enhancing program and retention to care in the Swiss Cohort. 9th International Conference on HIV Treatment and Prevention Adherence. Miami, Fl; 2014.

  49. Sevelius J, Johnson M, Saberi P (eds) (2014) Health Divas: a culturally relevant intervention to improve engagement in care among transgender women living with HIV. 9th International Conference on HIV treatment and Prevention Adherence. Miami, Fl.

  50. Teti M, Gerkovich M, Farnan R. Snapshots of adherence: photo-stories as a tool to promote medication use among people with HIV. 9th International Conference on HIV Treatment and Prevention Adherence. Miami, Fl; 2014.

  51. Lehrman S, Evans E, Brady K, Terrell C (eds) (2014) Early results from the Philadelphia Integrative Behavioral Health Initiative: Improved Retention in Care. 9th International Conference on HIV treatment and Prevention Adherence. Miami, Fl.

  52. Green K, Jones R, Ortiz-Ricard A (eds) (2014) Updating the evidence-based intervention pager messaging into a mobile application to improve adherence to antiretroviral treatment. 9th International Conference on HIV treatment and Prevention Adherence. Miami, Fl.

  53. Gross R, Zheng L, La Rosa A, Sun X, Rosenkranz S, Cardoso-Wagner S, et al. (eds) (2014) Partner-based intervention for adherence to second-line ART: a multinational trial (ACTG A5234). 2014 Conference on Retroviruses and Opportunistic Infections. Boston, Mass.

  54. Simoni JM, Wiebe JS, Sauceda JA, Huh D, Sanchez G, Longoria V, et al. A preliminary RCT of CBT-AD for adherence and depression among HIV-positive Latinos on the US-Mexico border: the Nuevo Dia study. AIDS Behav. 2013;17(8):2816–29.

    Article  PubMed Central  PubMed  Google Scholar 

  55. Centers for Disease Control and Prevention. HIV and AIDS among gay and bisexual men. 2009 [cited 2011 January 15, 2011]. Available from: http://www.cdc.gov/nchhstp/newsroom/docs/fastfacts-msm-final508comp.pdf.

  56. UNAIDS. UNAIDS Report on the Global AIDS epidemic. 2010. http://www.unaids.org/globalreport/global_report.htm.

  57. Ellis DA, Naar-King S, Cunningham PB, Secord E. Use of multisystemic therapy to improve antiretroviral adherence and health outcomes in HIV-infected pediatric patients: evaluation of a pilot program. AIDS Patient Care STDs. 2006;20(2):112–21.

    Article  PubMed  Google Scholar 

  58. McKay MM, Chase K, Baptiste D, Bell C, Coleman D, Madision S, et al. Family-level impact of the CHAMP family program: a community collaborative effort to support urban families and reduce youth HIV risk exposure. Fam Process. 2004;77:77–91.

    Google Scholar 

  59. Petersen I, Bhana A, Baillie K (2011) The feasibility of adapted group-based interpersonal therapy (IPT) for the treatment of depression by community health workers within the context of task shifting in South Africa. Commun Mental Health J:1–6.

  60. Bosworth K, Espelage D, DuBay T, Daytner G, Karageorge K. Preliminary evaluation of a multimedia violence prevention program for adolescents. Am J Health Behav. 2000;24:268–80.

    Article  Google Scholar 

  61. Bartholomew LK, Shegog R, Parcel GS, et al. Watch, discover, think, and act: a model for patient education program development. Patient Educ Couns. 2000;39(2):253–68.

    Article  CAS  PubMed  Google Scholar 

  62. Rubin DH, Leventhal JM, Sadock RT, et al. Educational intervention by computer in childhood asthma: a randomized clinical trial testing the use of a new teaching intervention in childhood asthma. Pediatrics. 1986;77:1–10.

    CAS  PubMed  Google Scholar 

  63. Brown SJ, Lieberman DA, Gemeny BA, Fan YC, Wilson DM, Pasta DJ. Educational video game for juvenile diabetes: results of a controlled trial. Med Inform (Lond). 1997;22:77–89.

    Article  CAS  Google Scholar 

  64. French D. Influence smoking cessation with computer-assisted instruction. AAOHN. 1986;34:391–4.

    CAS  Google Scholar 

  65. Tingen MS, Grimling LF, Bennet G, Gibson EM, Renew MM. A pilot study of preadolescents to evaluate a video game-based smoking prevention strategy. J Addict Nurs. 1997;9:118–24.

    Article  Google Scholar 

  66. Reis J, Riley W, Baer J. Interactive multimedia preventive alcohol education: an evaluation of effectiveness with college students. J Educ Comput Res. 2000;23:41–65.

    Article  Google Scholar 

  67. Safren S, Otto MW, Worth JL, Salomon E, Johnson W, Mayer K, et al. Two strategies to increase adherence to HIV antiretroviral medication: life-steps and medication monitoring. Behav Re Ther. 2001;39(10):1151–62.

    Article  CAS  Google Scholar 

  68. Remien RH, Mellins CA, Robbins RN, Kelsey R, Rowe J, Warne P, et al. Masivukeni: development of a multimedia based antiretroviral therapy adherence intervention for counselors and patients in South Africa. AIDS Behav. 2013;17(6):1979–91.

    Article  PubMed Central  PubMed  Google Scholar 

  69. Remien RH, Stirratt MJ, Dognin J, Day E, El-Bassel N, Warne P. Moving from theory to research to practice. Implementing an effective dyadic intervention to improve antiretroviral adherence for clinic patients. J Acquir Immune Defic Syndr. 2006;43 Suppl 1:S68–78.

    Google Scholar 

  70. Remien RH, Mellins C (2007) Long-term psychosocial challenges for people living with HIV: let’s not forget the individual in our global response to the pandemic. AIDS Supplement 5:S55-63.

  71. Remien R, Hirky E, Johnson MO, Weinhardt LS, Whittier D, Le GM. Adherence to medication treatment: facilitators and barriers among a diverse sample of HIV+ men and women in four U.S. Cities. AIDS Behav. 2003;7(1):61–72.

    Article  PubMed  Google Scholar 

  72. de Bruin M, Viechtbauer W, Schaalma HP, Kok G, Abraham C, Hospers HJ. Standard care impact on effects of highly active antiretroviral therapy adherence interventions: A meta-analysis of randomized controlled trials. Arch Intern Med. 2010;170(3):240–50.

    Article  PubMed  Google Scholar 

  73. Wagner GJ, Kanouse DE. Assessing usual care in clinical trials of adherence interventions for highly active antiretroviral therapy. JAIDS J Acquir Immune Defic Syndr. 2003;33(2):276–77.

    Article  Google Scholar 

  74. Safren S, O’Cleirigh C, Bullis J. CBT for adherence and depression (CBT-AD) in HIV-infected injection drug users: an RCT. J Consult Clin Psychol. 2011;80(3):404–15.

    Article  Google Scholar 

  75. Safren SA, O’Cleirigh CM, Bullis JR, Otto MW, Stein MD, Pollack MH. Cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected injection drug users: a randomized controlled trial. J Consult Clin Psychol. 2012;80(3):404.

    Article  PubMed Central  PubMed  Google Scholar 

  76. Safren S, O’Cleirigh CM, Tan J, et al. A randomized controlled trial of cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected individuals. Health Psychol. 2009;28(1):1–10.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

Drs. Robbins, Mellins, and Remien are supported by the HIV Center for Clinical and Behavioral Studies (P30-MH43520; PI: R. H. Remien, Ph.D.), and Dr. Spector is supported by a training grant from the National Institute of Mental Health (T32 MH19139, Behavioral Sciences Research in HIV Infection; PI: Theo Sandfort, PhD).

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Reuben N. Robbins, Anya Y. Spector, Claude A. Mellins, and Robert H. Remien declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive #15, New York, NY, 10032, USA

    Reuben N. Robbins, Anya Y. Spector, Claude A. Mellins & Robert H. Remien

Authors
  1. Reuben N. Robbins
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anya Y. Spector
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Claude A. Mellins
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert H. Remien
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Reuben N. Robbins.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Robbins, R.N., Spector, A.Y., Mellins, C.A. et al. Optimizing ART Adherence: Update for HIV Treatment and Prevention. Curr HIV/AIDS Rep 11, 423–433 (2014). https://doi.org/10.1007/s11904-014-0229-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11904-014-0229-5

Keywords

Search

Navigation