The Jumpstart Treatment Adherence Program is an HIV/AIDS antiviral project in a 900-patient HIV clinic. Participants must be either treatment naive patients who will start HIV antiviral medication, or treatment experienced patients who need to change medication due to treatment failure. Intensive treatment readiness services are provided before supervised treatment begins or changes. Enrollment began March 15, 1999. As of December 31st, 78 patients (57 Latinos, 20 African Americans, 1 African; 60 Males, 18 Females) have enrolled and 22 have been discharged. The intervention comprises an intensive intake interview, counseling with a health educator, peer education, ongoing outreach and contact, a home visit, referrals, supervised medication dispensing in a modified Directly Observed Therapy format, and interdisciplinary team management including medical and social work staff, and peer and health educators. The program evaluation includes both quantitative and qualitative methods. Program challenges, successes, and failures will be discussed. Delaying the initiation of medication in patients with remediable barriers to treatment, and indefinitely deferring medication when barriers to treatment are overwhelming, appears to improve clinical response. Factors associated with delaying or deferring treatment include mental illness, active substance abuse, homelessness and unstable housing, acute physical illness, travel, and legal and immigration problems. Of the first 28 patients starting treatment, 9/10 naive patients and 10/18 experienced patients had viral load below 400 copies after 1-3 months. Mean CD4 increased from 88 to 173. Data will be shown comparing historical controls with program patients, demonstrating significant clinical benefits of the program.
Learning Objectives: At the conclusion of the session, the participant will be able to describe the program and evaluation components of an innovative treatment adherence program, evaluate the preliminary results, and identify challenges faced in implementing the program
Keywords: Adherence, HIV Interventions
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: none
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.