Behavioral Intervention Improves Treatment Outcomes Among HIV-Infected Individuals Who Have Delayed, Declined, or Discontinued Antiretroviral Therapy: A Randomized Controlled Trial of a Novel Intervention

Marya Gwadz, Charles M. Cleland, Elizabeth Applegate, Mindy Belkin, Monica Gandhi, Nadim Salomon, Angela Banfield, Noelle Leonard, Marion Riedel, Hannah Wolfe, Isaiah Pickens, Kelly Bolger, De Shannon Bowens, David Perlman, Donna Mildvan

Research output: Contribution to journalArticle

Abstract

Nationally up to 60 % of persons living with HIV are neither taking antiretroviral therapy (ART) nor well engaged in HIV care, mainly racial/ethnic minorities. This study examined a new culturally targeted multi-component intervention to address emotional, attitudinal, and social/structural barriers to ART initiation and HIV care. Participants (N = 95) were African American/Black and Latino adults with CD4 < 500 cells/mm3 not taking ART, randomized 1:1 to intervention or control arms, the latter receiving treatment as usual. Primary endpoints were adherence, evaluated via ART concentrations in hair samples, and HIV viral load suppression. The intervention was feasible and acceptable. Eight months post-baseline, intervention participants tended to be more likely to evidence “good” (that is, 7 days/week) adherence (60 vs. 26.7 %; p = 0.087; OR = 3.95), and had lower viral load levels than controls (t(22) = 2.29, p = 0.032; OR = 5.20), both large effect sizes. This highly promising intervention merits further study.

Original languageEnglish (US)
Pages (from-to)1801-1817
Number of pages17
JournalAIDS and Behavior
Volume19
Issue number10
DOIs
StatePublished - Oct 14 2015

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Keywords

  • Antiretroviral therapy
  • Disparities
  • HIV/AIDS
  • Intervention
  • Motivational interviewing

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Gwadz, M., Cleland, C. M., Applegate, E., Belkin, M., Gandhi, M., Salomon, N., Banfield, A., Leonard, N., Riedel, M., Wolfe, H., Pickens, I., Bolger, K., Bowens, D. S., Perlman, D., & Mildvan, D. (2015). Behavioral Intervention Improves Treatment Outcomes Among HIV-Infected Individuals Who Have Delayed, Declined, or Discontinued Antiretroviral Therapy: A Randomized Controlled Trial of a Novel Intervention. AIDS and Behavior, 19(10), 1801-1817. https://doi.org/10.1007/s10461-015-1054-6