Effectiveness of an evidence-based intervention to improve treatment adherence, service utilization and viral load among HIV-seropositive adult alcohol users
Methods: Participants (n=243) from Miami, FL were randomized to the Holistic Health Recovery Program (HHRP-A) with cognitive remediation strategies or a comparison condition that provided only didactic general health information. Both conditions attended eight group sessions and provided self-report data on ART adherence, service utilization, and viral load (VL), and on two process variables—social support and stress—at baseline (T1), post-intervention (T2), 3-months (T3), and 6-months (T4). Repeated measures ANOVA and non-parametric alternatives were used to compare groups over time.
Results: Participants were ≥18 and ≤60 (=45.7 years old), 74% male, and 78% black. There were no significant differences in demographic or study measures by treatment group assignment at baseline. A significant difference (RR=1.55; p=.049) was observed between treatment groups in the proportions of participants reporting >95% adherence at T4 (HPC=80.6% versus HHRP-A=90.3%). Also at T4, HHRP-A participants were more likely (74.6%; RR=1.49; p=.033) to report an undetectable VL than in HPC (56.7%). Regarding process variables, HHRP-A showed better social support over time than HPC; this result approached significance [F=2.37, p<.06]. Support was significantly correlated with adherence at T4 (r=.28, p<.05).
Conclusions: Implementing risk reduction interventions that incorporate cognitive remediation strategies could improve health outcomes for HIV-seropositive substance users.
Learning Areas:Implementation of health education strategies, interventions and programs
Evaluate the effectiveness of an evidence-based intervention for improving treatment adherence and reducing viral load among people living with HIV. Discuss the use of cognitive remediation strategies in risk reduction for people living with HIV who have neurocognitive impairment.
Keyword(s): HIV/AIDS, Adherence
Qualified on the content I am responsible for because: I am experienced in the delivery of HIV-related education and interventions. I have spent much time on data management and analysis for this study. I presented previously at APHA on preliminary (cross sectional) outcomes from this study.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.