HAART can dramatically reduce HIV-associated morbidity and mortality. Its effectiveness, however, is contingent upon near perfect adherence. Adherence to HAART is very difficult due to the number of pills prescribed, scheduling requirements, and side effects. Many patients require support to maintain adherence, yet little is known about which supports are effective.
This analysis uses data from 10 adherence programs, which provide a variety of services, including education, medication reminders, and skills-building. All enrollees participate in baseline and follow-up assessments, which include sociodemographic, health status and adherence data. Service utilization data are collected at all adherence-related visits. Data from 435 individuals were analyzed to identify tools and services associated with adherence at first follow-up assessment, generally conducted 3 months after enrollment.
More than 80% of the sample are African-American or Latino, 47% did not graduate from high school, and 35% have been diagnosed with mental illness. For those on HAART at baseline and first follow-up, the mean 3-day adherence rate was 83.2% at baseline and 88.9% at first follow-up (paired t-test p<.01). Two-thirds of the programs had improvements in overall adherence, indicating that a variety of models may be successful. In bivariate analysis, tools and services associated with perfect 3-day adherence include use of a pillbox, receipt of written instructions, pharmacy contacts, and receipt of incentives (p<.05). In ongoing analysis we are examining the stability of these effects over time, dose effects, and thresholds beyond which additional services show no significant benefit.
Learning Objectives: At the conclusion of the session, participants will be able to: 1. Describe the importance of and challenges to adherence to HAART. 2. Discuss a range of interventions used to support adherence. 3. List interventions associated with high levels of adherence.
Keywords: Adherence, HIV/AIDS
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.