Impact of an Adherence Program on the Health and Outlook of HIV-Infected Patients Failing Antiretroviral Therapy.
BACKGROUND
We prospectively studied the impact of an adherence counselor on the outcome of patients failing antiretroviral therapy because of nonadherence.


METHODS
Forty-six patients, identified as chronically nonadherent were enrolled. Individual attention was provided using the information, motivation and behavioral methodology. HIV RNA (viral load, in copies/mL), CD4 count (in cells/mm(3)), and body weight before and after the adherence counselor were measured. Qualitative outcome and patient satisfaction were assessed by deidentified third-party interviews.


RESULTS
Over half completed at least 1 year; only 8 patients were lost to follow-up. Mean CD4 counts increased significantly (P < .05) for completers at 6 and 12 months. Viral loads decreased between baseline and 6 months. Most clients reported subjective benefit from working with the adherence counselor.


CONCLUSIONS
Although few clients showed complete virologic suppression, the value of an adherence counselor was validated. Longer term adherence programs should be evaluated.
Parry
Michael F
MF
Division of Infectious Diseases, Department of Medicine, and the Clinical Effectiveness Program, The Stamford Hospital, Stamford, Connecticut 06904, USA.
Wright
Pamela
P
Stewart
Julie
J
McLeod
Gavin X
GX
Tucker
James
J
Weinberg
Amy R
AR
D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000188:drug therapy; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D019562:Viral Load
D019380:Anti-HIV Agents