Antiretroviral Adherence Interventions: Translating Research Findings to the Real World Clinic
- 630 Downloads
The success of potent combination antiretroviral therapy (ART) for HIV infection is compromised primarily by failure to maintain optimal levels of adherence over the long term. Recent reviews suggest behavioral interventions to promote ART adherence can have significant effects, but these tend to be small and to diminish over time; sustained improvements in biomarkers are particularly elusive. In this article, we update current reviews, focusing specifically on the 13 studies evaluating behavioral interventions to promote ART adherence published since September 2007. We describe the range of intervention strategies employed and qualitatively summarize findings of their efficacy. In conclusion, we consider implications and offer strategies for enhancing adherence in clinic-based HIV care prior to ART initiation, at initiation, and over the course of treatment.
KeywordsHIV/AIDS ART Adherence Interventions Review
No potential conflicts of interest relevant to this article were reported.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 8.• Amico KR, Harman JJ, O’Grady M, Johnson B: Research synthesis of ART adherence interventions: A synthesis of published adherence intervention outcomes research from 1996 to September. Paper presented at 4th Annual HIV Treatment Adherence Conference of the International Association of Providers in AIDS Care. Miami, FL; April 2009. A meta-analysis of 48 published studies of antiretroviral adherence promotion interventions through September 2007 that systematically considers their efficacy.Google Scholar
- 9.• Cote J, Godin G, Ramirez-Garcia P, et al: Program development for enhancing adherence to antiretroviral therapy among persons living with HI. AIDS Patient Care STD 2008, 22:965–975. An excellent example of intervention mapping and its application in the development of theory-based adherence interventions.Google Scholar
- 12.• Hirsch JD, Rosenquist A, Best BM, Miller TA, et al.: Evaluation of the first year of a pilot program in a community pharmacy: HIV/AIDS Medication Therapy Managment for Medi-Cal Beneficiaries. J Manag Care Pharmacy 2009, 15:32–41. This intervention approach was at the level of providing incentives through state funding for pharmacies to adopt more comprehensive approaches to adherence.Google Scholar
- 13.Fisher JD, Fisher WA: Theoretical approaches to individual-level change in HIV risk behavior. In Handbook of HIV Prevention. Edited by Peterson R, DiClemente J. New York: Klewer Academic/Plenum; 2000:3–55Google Scholar
- 15.Prochazka JO, DiClemente CC: Stages of change in the modification of problem behaviors. In Progress in Behavior Change Modification. Edited by Herson M, Miller PM, Eisler R. New York: Wadsworth Publishing; 1992:184–218.Google Scholar
- 16.Rosenbaum MA: A model for research on self-regulation: reducing the schism between behaviorism and general psychology. In Unifying Behavior Therapy. Edited Eifert GH, Evans IM. New York: Springer Publishing Co.; 1990:126–149.Google Scholar
- 20.Simoni JM, Huh D, Frick PA, et al.: Peer support and pager messaging to promote antiretroviral modifying therapy in Seattle: a randomized controlled Trial. J Acquir Immune Defic Syndr 2009, 52:499–507.Google Scholar
- 28.Sabin LL, Bachman DeSilva M, Hamer DH, et al.: Using electronic drug monitor feedback to improve adherence to antiretroviral therapy among HIV-positive patients in China. AIDS Behav 2009 Sept 22 (Epub ahead of print).Google Scholar
- 29.• Simoni JS, Amico KR, Pearson CR, Malow RM: Strategies for promoting adherence to antiretroviral therapy: a review of the liteature. Curr Infect Dis Rep 2008, 10:515–521. This is a qualitative review of adherence intervention studies that highlights some of the most recent and innovative research in the areas of patient education and case management, modified early direct observed therapy, contingency management, and interventions emphasizing social support.Google Scholar