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539Peer-led intervention to address non-adherence among adults linked to HIV medical care but failing treatment

Year: 2014

Type: conference-abstract

Abstract: Background. HIV testing and linkage initiatives are identifying undiagnosed cases and establishing medical care for these individuals. However, non-adherence to antiretroviral (ART) treatment remains a prevalent, vexing problem even among the 'linked' segment of the U.S. HIV population. Methods. A feasibility study with ART experienced adult patients (n = 20) linked to HIV medical care but failing treatment. Patients from one safety-net urban clinic were randomized to a theory-driven, peer-led HIV medication adherence intervention named 'Ready' designed to enhance readiness for the healthful behavior change of adherence or to a time equivalent 'healthy eating' control arm. Lay individuals living with HIV were trained to facilitate 'Ready', which consisted of six weekly one-hour sessions and one booster. Patients were followed for 24 weeks. Primary aims were feasibility of the peer-led intervention and impact on adherence (measured by HIV PCR, MEMS and pharmacy refills). Mediator (readiness for healthful behavior change) and moderator (depression and social support) analyses were done. Results. Patients had failed a mean of three prior ART regimens due to non-adherence. Only those randomized to ‘Ready’ had significantly improved adherence. MEMS and pharmacy refill data correlated with viral load log drop. Higher readiness for healthful behavior change, particularly re-evaluation of lifestyle, correlated with viral load drop and approached significance (0.09). No significant changes were observed in depression or social support. HIV RNA PCR log drop: baseline to 12 & 24 wks post-intervention Conclusion. The peer-led ‘Ready’ medication adherence intervention was feasible, enhanced readiness for healthful behavior change and had a positive impact on adherence among adults who had repeatedly failed HIV treatment due to non-adherence. A larger multi-center study with longer follow-up is needed to examine ease of intervention dissemination and efficacy. Disclosures. All authors: No reported disclosures.

Source: Open Forum Infectious Diseases

DOI: 10.1093/ofid/ofu051.58

Authors: David Mckinsey, Maithe Enriquez, An-Lin Cheng

Institutions: University of Missouri, University of Missouri–Kansas City

Language: English

Topic: HIV/AIDS Research and Interventions

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,053