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Randomized Controlled Trial
. 2011 Mar;101(3):531-8.
doi: 10.2105/AJPH.2010.197608. Epub 2011 Jan 13.

Integrated behavioral intervention to improve HIV/AIDS treatment adherence and reduce HIV transmission

Seth C Kalichman  1 , Chauncey Cherry, Moira O Kalichman, Christina M Amaral, Denise White, Howard Pope, Connie Swetzes, Lisa Eaton, Rene Macy, Demetria Cain
Affiliations
Randomized Controlled Trial

Integrated behavioral intervention to improve HIV/AIDS treatment adherence and reduce HIV transmission

Seth C Kalichman et al. Am J Public Health. 2011 Mar.

Abstract

Objectives: We conducted a randomized clinical trial to test an integrated behavioral intervention designed to enhance using HIV treatment as prevention by improving medication adherence, reducing risks for other sexually transmitted infections, and minimizing risk compensation beliefs.

Methods: Individuals living with HIV/AIDS (n = 436) participated in a randomized clinical trial testing an intensive behavioral intervention aimed at reducing HIV transmission risks compared with an attention control condition. We used unannounced pill counts to monitor antiretroviral therapy adherence and computerized interviews to measure risk behaviors.

Results: The integrated transmission risk reduction intervention demonstrated increased antiretroviral therapy adherence and less unprotected intercourse with nonseroconcordant partners at 3- and 6-month follow-ups as well as fewer new sexually transmitted infections diagnosed over the 9-month follow-up period (adjusted odds ratio = 3.0; P < .05; 95% confidence interval = 1.01, 9.04). The integrated intervention also reduced behavioral risk compensation beliefs.

Conclusions: A theory-based integrated behavioral intervention can improve HIV treatment adherence and reduce HIV transmission risks. HIV treatment as prevention should be bundled with behavioral interventions to maximize effectiveness.

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Figures

FIGURE 1
FIGURE 1
Flow of participants through the randomized trial: Integrated HIV Intervention Trial, Atlanta, GA, March 2005–November 2009. Note. ACASI = audio computer-assisted self-interview.
FIGURE 2
FIGURE 2
Estimated means (SE) for ART adherence outcomes over 12 months of observation: Integrated HIV Intervention Trial, Atlanta, GA, March 2005–November 2009. Note. ART = antiretroviral therapy.
FIGURE 3
FIGURE 3
Structural equation model for intervention effects on primary outcomes and association of primary outcomes to health-related endpoints: Integrated HIV Intervention Trial, Atlanta, GA, March 2005–November 2009. Note. ART = antiretroviral therapy. *P < .05; **P < .01
See this image and copyright information in PMC

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