Motivational Enhancement System for Adherence (MESA): pilot randomized trial of a brief computer-delivered prevention intervention for youth initiating antiretroviral treatment.
OBJECTIVE
To pilot test a two-session computer-delivered motivational intervention to facilitate adherence among youth with HIV newly prescribed antiretroviral treatment (ART).


METHODS
Youth (N = 76) newly prescribed ART were recruited from 8 sites, and were randomized to the intervention or an active nutrition and physical activity control. Primary outcomes were HIV-1 viral load at baseline, 3 months, and 6 months, and self-reported adherence at 3 and 6 months.


RESULTS
Satisfaction ratings were high. Effect sizes suggested that the intervention group showed a greater drop than controls in viral load from baseline to 6 months (Cohen's d = 0.39 at 3 months; d = 0.19 at 6 months), and had greater percent undetectable by 6 months (d = 0.28). Effects sizes were medium to large for 7-day and weekend adherence.


CONCLUSIONS
A brief computer-delivered motivational intervention showed promise for youth starting ART and is ready to be tested in a full-scale clinical trial.
Wayne State University School of Medicine, Detroit, MI, USA. snaarkin@med.wayne.edu
Sylvie
S
Naar-King
Angulique Y
AY
Outlaw
Moussa
M
Sarr
Jeffrey T
JT
Parsons
Marvin
M
Belzer
Karen
K
Macdonell
Mary
M
Tanney
Steven J
SJ
Ondersma
D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D009042:Motivation; D017060:Patient Satisfaction; D010865:Pilot Projects; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
D044966:Anti-Retroviral Agents
HIV; adherence; adolescent; eHealth