Adherence to HAART can be difficult for people with HIV, given the circumstances around therapy. This is a randomized clinical trial examining the effectiveness of a home-based nursing intervention designed to help people with HIV take medication more effectively. The theoretical framework is based on the pedagogic philosophy of Paolo Freire which maintains that one's learning is affected by one's social context. Behavioural change is dependent not only on an individual, but also on one's social context. In this intervention, a nurse and peer educator work together with a client; through active listening, dialogue, and praxis, the client sees his or her life in the social context and becomes empowered, thus aiding adherence to HAART. Data are presented from an interim analysis. The trial has 173 participants. 52% are male, 47% female, and 1% transgendered. 43% describe themselves Caucasian, 35% African-American, 20% Hispanic, and 2% Native-American. The mean age is 43 years (22-63). Mean baseline adherence, measured by MEMS, is 68% in controls and 60% in the intervention arm (p=0.22). A mixed-effects model using data to date suggests that mean adherence has decreased significantly from baseline for both groups by time t=3months, and has remained constant at times t=6months and t=9months. It remains constant for the intervention group at t=12months, but decreases significantly for the control group (p=0.0002). These data suggest the intervention is effective at maintaining adherence. Adherence in the control arm may decrease over time as the novelty of the study subsides. See info.med.yale.edu/nursing/athena/athena.html
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. Articulate the principles involved in the intervention (ie a Freirian home-based nursing intervention) 2. Gain knowledge in the area of MEMS cap use and self-report as measures of adherence 3.Develop insight into the various types of adherence work being carried out to-day
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.