title: Impact of an Adherence Program on the Health and Outlook of HIV-Infected Patients Failing Antiretroviral Therapy.
abstract: 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.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, and the Clinical Effectiveness Program, The Stamford Hospital, Stamford, Connecticut 06904, USA.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Parry
authors.forename: Pamela
authors.initials: P
authors.lastname: Wright
authors.forename: Julie
authors.initials: J
authors.lastname: Stewart
authors.forename: Gavin X
authors.initials: GX
authors.lastname: McLeod
authors.forename: James
authors.initials: J
authors.lastname: Tucker
authors.forename: Amy R
authors.initials: AR
authors.lastname: Weinberg
mesh_terms: 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
chemical_list: D019380:Anti-HIV Agents