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Antiretroviral Adherence Interventions: Translating Research Findings to the Real World Clinic

Current HIV/AIDS Reports volume 7, pages 44–51 (2010)Cite this article

Abstract

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.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Chesney MA, Morin M, Sherr L: Adherence to HIV combination therapy. Soc Sci Med 2000, 50:1599–1605.

    Article  PubMed  CAS  Google Scholar 

  2. Williams AB: Adherence to highly active antiretroviral therapy. Nurs Clin North Am 1999, 34:113–129.

    PubMed  CAS  Google Scholar 

  3. Mannheimer S, Friedland G, Matts J, et al.: The consistency of adherence to an antiretroviral therapy predicts biologic outcomes for human immunodeficiency virus-infected persons in clinical trials. Clin Infect Dis 2002, 34:1115–1121.

    Article  PubMed  Google Scholar 

  4. Paterson DL, Swindells S, et al.: Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med 2000, 133:21–30.

    PubMed  CAS  Google Scholar 

  5. Ross L, Lim LM, Wine B, et al.: Prevalence of antiretroviral drug resistance and resistance-associated mutations in antiretroviral therapy-naïve HIV-infected individuals from 40 United States cities. HIV Clin Trial 2007, 8:1–8.

    Article  Google Scholar 

  6. Amico KR, Harman JJ, Johnson BT: Efficacy of antiretroviral therapy adherence interventions: a research synthesis of trials, 1996 to 2004. J Acquir Immune Defic Syndr 2006, 41:285–297.

    Article  PubMed  Google Scholar 

  7. Simoni JM, Pearson CR, Pantalone DW, et al.: Efficacy of interventions in improving highly active antiretroviral therapy adherence and HIV-1 RNA viral load: a meta-analytic review of randomized controlled trials. J Acquir Immune Defic Syndr December 2006, 43(Suppl 1):S23–S35.

    Article  Google Scholar 

  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.

  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.

  10. Lester RT, Mills EJ, Kariri A, et al.: The HAART cell phone adherence trial (WelTel Kenya I): a randomized controlled trial protocol. Trials 2009, 10:87–95.

    Article  PubMed  CAS  Google Scholar 

  11. Nishigaki M, Shimada M, Ideda K, et al.: Process and contents of telephone concultations between registered nurses and clients with HIV/AIDS in Japan. J Assoc Nurses AIDS Care 2007, 18:85–96.

    Article  PubMed  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.

  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; 2000:3–55

    Google Scholar 

  14. Fisher JD, Fisher WA, Amico KR, Harman JJ: An information-motivation-behavioral skills model fo adherence to antoretroviral therapy. Health Psychology 2006, 25:262–473.

    Article  Google 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 

  17. Sampaio-Sa M, Page-Shafer K, Bangsberg DR, et al.: 100% Adherence study: educational workshops vs. video sessions to improve adherence among ART-naïve patients in Salvador, Brazil. AIDS Behav 2008, 12:S54–S62.

    Article  PubMed  Google Scholar 

  18. Whol AR, Garland WH, Witt MD, et al.: An adherence-focused case management intervention for HIV-positive patients in a public care setting. J HIV/AIDS Social Serv 2009, 8:80–94.

    Article  Google Scholar 

  19. Deering KN, Shannon K, Sinclair H, et al.: Piloting a peer-driven intervention model to increase access and adherence to antiretroviral therapy and HIV care among street-entrenched HIV-positive women in Vancouver. AIDS Patient Care STD 2009, 23:603–609.

    Article  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 

  21. Pearson CR, Micek MA, Simoni JM, et al.: Randomized control trial of peer-delivered, modified directly observed therapy for HAART in Mozambique. J Acquir Immune Defic Syndr 2007, 46:238–244.

    Article  PubMed  CAS  Google Scholar 

  22. DiIorio C, McCarty F, Resnicow K, et al.: Using motivational interviewing to promote adherence to antiretroviral medications: a randomized controlled study. AIDS Care 2008, 20:273–283.

    Article  PubMed  CAS  Google Scholar 

  23. Parsons JT, Colub SA, Rosof E, Holder C: Motivational interviewing and Cognitive-Behavioral interventiont o improve HIV medication adherence among hazardous drinkers: a randomized controlled trial. J Acquir Immune Defic Syndr 2007, 46:443–450.

    Article  PubMed  Google Scholar 

  24. Reynolds NR, Testa MA, Su M, et al.: Telephone support to improve antiretroviral medication adherence: a multisite, randomized controlled trial. J Acquir Immune Defic Syndr 2008, 47:62–68.

    Article  PubMed  Google Scholar 

  25. Johnson MO, Charlebois E, Morin SF, et al.: Effects of a behavioral intervention on antiretroviral medication adherence among people living with HIV: The Healty Living Project randomized controlled study. J Acquir Immune Defic Syndr 2007, 46:574–580.

    Article  PubMed  Google Scholar 

  26. Lopez E, Jones DL, Ishii M, et al.: HIV mediation adherence and substance use: The Smartest Women’s Project. Am J Infect Dis 2007, 3:240–247.

    Article  PubMed  Google Scholar 

  27. Koenig LJ, Pals SL, Bush T, et al.: Raondomized controlled trila of an interventiont o prevent adherence failure among HIV-infected patients initiating antiretroviral therapy. Health Psychol 2008, 27:159–169.

    Article  PubMed  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).

  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.

  30. Sandelowski M, Voils CI, Chang Y, Lee E: A systematic review comparing antiretroviral adherence descriptive intervention studies conducted in the USA. AIDS Care 2009, 21:953–966.

    Article  PubMed  Google Scholar 

  31. Segal-Isaacson CJ, Tobin JN, Weiss SM, et al.: Improving dietary habits in disadvantaged women with HIV/AIDS: The SMART/EST Women’s Project. AIDS Behav 2006, 10:659–670.

    Article  PubMed  CAS  Google Scholar 

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Disclosure

No potential conflicts of interest relevant to this article were reported.

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Affiliations

  1. Department of Psychology, University of Washington, Campus Box 351525, Seattle, WA, 98195-1525, USA

    Jane M. Simoni

  2. Center for Health, Intervention & Prevention, University of Connecticut, 2006 Hillside Road, Storrs, CT, 06269, USA

    K. Rivet Amico

  3. Center for Health, Intervention & Prevention, Department of Psychology, University of Connecticut, 2006 Hillside Road, Unit 1248, Storrs, CT, 06269, USA

    Laramie Smith

  4. Department of Psychology, University of Washington, Campus Box 351525, Seattle, WA, 98195-1525, USA

    Kimberly Nelson

Authors
  1. Jane M. Simoni
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  2. K. Rivet Amico
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  3. Laramie Smith
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  4. Kimberly Nelson
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Corresponding author

Correspondence to Jane M. Simoni.

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Simoni, J.M., Amico, K.R., Smith, L. et al. Antiretroviral Adherence Interventions: Translating Research Findings to the Real World Clinic. Curr HIV/AIDS Rep 7, 44–51 (2010). https://doi.org/10.1007/s11904-009-0037-5

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  • DOI: https://doi.org/10.1007/s11904-009-0037-5

Keywords

  • HIV/AIDS
  • ART
  • Adherence
  • Interventions
  • Review