4238.0: Tuesday, October 23, 2001 - 2:30 PM

Abstract #27875

Combining direct services with individual counseling and support groups to improve antiretroviral adherence

Angela Rita, CSW1, Sally Findley, PhD2, Paul Colson, PhD1, Julie Franks, PhD1, Harry Dohnert1, and Sharon B Mannheimer, MD3. (1) Harlem Hospital Center, Columbia University, 506 Lenox Avenue Rm 3101-A, New York, NY 10037, (212) 939-4309, ar836@columbia.edu, (2) Joseph L. Mailman School of Public Health, Columbia University, 600 West 168th Street, Fourth floor, 10032, (3) Harlem Hospital Center, Columbia University College of Physicians and Surgeons, 506 Lenox Avenue rm 3101-A, New York, NY 10037

Combined individual and group therapy is an effective strategy for promoting adherence to antiretroviral therapy. It is a critical component of the intervention we deliver to HIV-infected participants, largely African-American and Latino, in an urban setting. The intervention is premised on Prochaska's Stages of Change model and integrates case management, health education, peer support, individual counseling, and group therapy to assist clients through the stages toward becoming adherent to antiretroviral therapy. Combined individual and group therapy is directed by a CSW-level therapist-case manager (TCM) who first assesses individual client's needs and strengths. Specific adherence barriers are identified and the TCM works with clients to establish a plan to address those barriers. Individual therapy allows clients to explore their feelings about living with HIV and adherence. Group therapy transpires in social support groups facilitated by the TCM. Group members validate feelings, share life experiences, help each other identify barriers to adherence, and sustain each other's progress. The goal of combined therapy is to establish trust, create a partnership for adherence, improve self-efficacy, and set realistic goals. 42 out of 120 clients have participated in weekly support groups, with an average of 25 per session. Attendance is regular, and clients report great satisfaction with the group. In addition to a better understanding of medications and their side effects, clients report learning more about themselves. They are pleased to share their adherence accomplishments and feel they are establishing trusting relationships with the staff and their fellow participants.

Learning Objectives: 1. To describe the advantages of a combined individual and group therapy for promoting adherence. 2. To assess the value of the Stages of Change Model for promoting adherence. 3. To identify key factors in promoting adherence in a hard-to-reach population.

Keywords: HIV Interventions, Adherence

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