5116.0: Wednesday, October 24, 2001 - Table 9

Abstract #21203

Readiness for HIV medication adherence

Linda M. Mundy, MD, Gabrielle Highstein, PhD, Jacquelynn Meeks, Ph D, Lauren Marshall, BS, Jill Cacciabando, BS, and Paul Thompson, PhD. Medicine, Washington University School of Medicine, 660 S. Euclid, Campus box 8051, St. Louis, MO 63110, 314-454-8354, lmundy@imgate.wustl.edu

Readiness assessment for adherence to highly active retroviral therapy (HAART) can be daunting and is not well correlated with patient characteristics or health care provider predictions. At baseline, 17% of 198 women eligible for HAART in our Midwest comprehensive HIV care program had been prescribed HAART and achieved a six-month durable suppression of HIV RNA. Using the Transtheoretical Model of Behavior Change (TMC), we developed a structured approach to HAART readiness assessment to increase the success rate of durable HIV suppression among women eligible for and prescribed HAART. Methods: Among the first 90 adolescent and adult women enrolled, 36 have had formal assessment of readiness stages and decisional balance, HAART regimens started or continued, adherence team support, and available baseline and 8-week follow-up HIV RNA results. Results: For the initial assessment of participants with Preparatory or higher staged readiness for HAART, 12 women were in Preparation and 24 were in Action/maintenance. The majority of women (n=21; 58%) were HAART-experienced and 15 were HAART naive. At the first quarterly follow-up assessment, stage advancement from Preparation to Action/maintenance was evident for 10 women. When success was defined as a HIV RNA of <400 copies/ml. or >0.5 log reduction from baseline viral load, 32 of 36 (89%) achieved success at 8 weeks follow-up. Conclusions: Preliminary findings suggest that a structured approach to readiness assessment for HAART using the TMC approach may correlated with short-term HIV suppression.

Learning Objectives: 1. To identify a structured approach to readiness assessment for adherence to highly active antiretroviral therapies (HAART). 2. To list the decisional balance (pros and cons) for readiness assessment to HAART adherence. 3. To describe how the use of readiness assessment can be correlated with durable HIV suppression.

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.

The 129th Annual Meeting of APHA