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Randomized Controlled Trial
. 2015 Oct;19(10):1801-17.
doi: 10.1007/s10461-015-1054-6.

Behavioral intervention improves treatment outcomes among HIV-infected individuals who have delayed, declined, or discontinued antiretroviral therapy: a randomized controlled trial of a novel intervention

Marya Gwadz  1 , Charles M Cleland  2 , Elizabeth Applegate  3 , Mindy Belkin  4 , Monica Gandhi  5 , Nadim Salomon  6 , Angela Banfield  7 , Noelle Leonard  8 , Marion Riedel  9 , Hannah Wolfe  10 , Isaiah Pickens  11 , Kelly Bolger  12 , DeShannon Bowens  13 , David Perlman  14 , Donna Mildvan  15 ; Heart to Heart Collaborative Research Team
Affiliations
Randomized Controlled Trial

Behavioral intervention improves treatment outcomes among HIV-infected individuals who have delayed, declined, or discontinued antiretroviral therapy: a randomized controlled trial of a novel intervention

Marya Gwadz et al. AIDS Behav. 2015 Oct.

Abstract

Nationally up to 60 % of persons living with HIV are neither taking antiretroviral therapy (ART) nor well engaged in HIV care, mainly racial/ethnic minorities. This study examined a new culturally targeted multi-component intervention to address emotional, attitudinal, and social/structural barriers to ART initiation and HIV care. Participants (N = 95) were African American/Black and Latino adults with CD4 < 500 cells/mm(3) not taking ART, randomized 1:1 to intervention or control arms, the latter receiving treatment as usual. Primary endpoints were adherence, evaluated via ART concentrations in hair samples, and HIV viral load suppression. The intervention was feasible and acceptable. Eight months post-baseline, intervention participants tended to be more likely to evidence "good" (that is, 7 days/week) adherence (60 vs. 26.7 %; p = 0.087; OR = 3.95), and had lower viral load levels than controls (t(22) = 2.29, p = 0.032; OR = 5.20), both large effect sizes. This highly promising intervention merits further study.

Keywords: Antiretroviral therapy; Disparities; HIV/AIDS; Intervention; Motivational interviewing.

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Figures

Fig. 1
Fig. 1
Description of the Heart to Heart intervention components
Fig. 2
Fig. 2
HTH consort diagram
Fig. 3
Fig. 3
Intervention impact on tenofovir (TFV) concentration in hair samples and on viral load. a Tenofovir concentration in hair by treatment condition. b Viral load by ART prescription and treatment condition
See this image and copyright information in PMC

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