Michael Chung and colleagues show that intensive early adherence counseling at HAART initiation resulted in sustained, significant impact on adherence and virologic treatment failure, whereas use of an alarm device had no effect

A Calmy

A Sarna

A Tuldra

AD Harries

AK Sethi

Barbra A. Richardson

C Orrell

C Pradier

CJ Gill

CR Pearson

DGJ McNeil

DL Paterson

DR Bangsberg

Edward J. Mills

EJ Mills

ET Katabira

F Maggiolo

G Wagner

Grace C. John-Stewart

HL Behforouz

J Donnelly

J Wise

James N. Kiarie

Jane M. Simoni

JB Nachega

JD Fisher

JG Carlucci

JL Aldous

JM Simoni

JS Stringer

Julie Overbaugh

JW Mellors

K Wools-Kaloustian

Kenneth Tapia

KR Amico

L Ferradini

L Osterberg

M Martin

MC Hosseinipour

Mena Attwa

MH Chung

MH Watt

Michael H. Chung

N Ford

NA Cooperman

P Frick

P Severe

PA Frick

RC Rathbun

RT Lester

S Emery

S Mannheimer

S Rueda

Sarah Benki-Nugent

SB Mannheimer

SJ Pocock

TR Cressey

WR Miller

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PubMed

Behavioral interventions that promote adherence to antiretroviral medications may decrease HIV treatment failure. Antiretroviral treatment programs in sub-Saharan Africa confront increasing financial constraints to provide comprehensive HIV care, which include adherence interventions. This study compared the impact of counseling and use of an alarm device on adherence and biological outcomes in a resource-limited setting.1.0) compared to those who did not use an alarm. Neither counseling nor alarm was significantly associated with mortality or rate of immune reconstitution.Intensive early adherence counseling at HAART initiation resulted in sustained, significant impact on adherence and virologic treatment failure during 18-month follow-up, while use of an alarm device had no effect. As antiretroviral treatment clinics expand to meet an increasing demand for HIV care in sub-Saharan Africa, adherence counseling should be implemented to decrease the development of treatment failure and spread of resistant HIV.Please see later in the article for the Editors' Summar

Chung Michael H.

Richardson Barbra A.

Tapia Kenneth

Benki-Nugent Sarah

Kiarie James N.

Simoni Jane M.

Overbaugh Julie

Attwa Mena

John-Stewart Grace C.

Public Library of Science (PLOS)

A Randomized Controlled Trial Comparing the Effects of Counseling and Alarm Device on HAART Adherence and Virologic Outcomes

BackgroundBehavioral interventions that promote adherence to antiretroviral medications may decrease HIV treatment failure. Antiretroviral treatment programs in sub-Saharan Africa confront increasing financial constraints to provide comprehensive HIV care, which include adherence interventions. This study compared the impact of counseling and use of an alarm device on adherence and biological outcomes in a resource-limited setting.Methods and findingsA randomized controlled, factorial designed trial was conducted in Nairobi, Kenya. Antiretroviral-naïve individuals initiating free highly active antiretroviral therapy (HAART) in the form of fixed-dose combination pills (d4T, 3TC, and nevirapine) were randomized to one of four arms: counseling (three counseling sessions around HAART initiation), alarm (pocket electronic pill reminder carried for 6 months), counseling plus alarm, and neither counseling nor alarm. Participants were followed for 18 months after HAART initiation. Primary study endpoints included plasma HIV-1 RNA and CD4 count every 6 months, mortality, and adherence measured by monthly pill count. Between May 2006 and September 2008, 400 individuals were enrolled, 362 initiated HAART, and 310 completed follow-up. Participants who received counseling were 29% less likely to have monthly adherence ConclusionsIntensive early adherence counseling at HAART initiation resulted in sustained, significant impact on adherence and virologic treatment failure during 18-month follow-up, while use of an alarm device had no effect. As antiretroviral treatment clinics expand to meet an increasing demand for HIV care in sub-Saharan Africa, adherence counseling should be implemented to decrease the development of treatment failure and spread of resistant HIV

Michael H Chung

Barbra A Richardson

James N Kiarie

Jane M Simoni

Grace C John-Stewart

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A randomized controlled trial comparing the effects of counseling and alarm device on HAART adherence and virologic outcomes.

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A Randomized Controlled Trial Comparing the Effects of Counseling and Alarm Device on HAART Adherence and Virologic Outcomes

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