A Videophone-Delivered Medication Adherence Intervention for Persons Living With HIV: A Case Study of a Rural Participant

Background: Consistent adherence to antiretroviral therapy (ART) is required for the suppression of HIV. However, maintaining adequate adherence is challenging for many persons living with HIV, particularly those living in rural areas. The goal of an ongoing NIMH-funded study is to test the feasibility and efficacy of a medication adherence intervention delivered via videophones to urban and rural persons living with HIV/AIDS. Methods: A case study of “George,” a 50-year-old, HIV-positive gay white man living in rural Ohio is presented in this abstract. Videophone-delivered pill counts conducted before the intervention revealed a baseline adherence rate of 73.5%. A social worker based in New York conducted eight videophone intervention sessions (most 15 minutes in length) with George. The intervention was based upon Nancy Reynolds' “HAART Care” program. Because George frequently forgot to take his pills with him when he left his house each morning, a primary goal involved enabling George to remember to place his pills by his wallet and keys every evening. Results: George's post-intervention adherence rates improved substantially compared to his pre-intervention level: 92.9% at one-week follow-up; 100% at one-month; 98.5% at two-month; and 80.1% at three-month. Conclusion: This case study suggests that videophones offer a feasible, efficacious, and potentially cost-effective means by which to improve and assess ART adherence. Booster sessions are now being used to help maintain initial results of the intervention. Videophone-based interventions might be particularly appropriate for HIV-infected rural persons, because they typically lack easy access to resources that can facilitate their ART adherence efforts.