Marseille 2007
| Abstract #21 - Improving HIV Medication Adherence and Health Outcomes among Men and Women with Alcohol Problems | ||||
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Session: 41.7: Drugs Alcohol and Potions (Parallel) on Tuesday @ 16.30-18.30 in 3 Chaired by Jeffrey Weiss, Biljana Ristic Authors: Presenting Author: Dr Jeffrey Parsons - Hunter College - CUNY, United States |
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| Additional Authors: Dr Sarit Golub, | ||||
| Aim: Alcohol use and alcohol-related problems have been shown to be more common among HIV+ persons, compared to the general population. Further, alcohol use and abuse is associated with immunosuppression among HIV+ persons, and research suggests that it is a significant factor in non-adherence to antiretroviral medications. This study presents efficacy data of an intervention, based on the Information-Motivation-Behavioral Skills (IMB) theory which was designed to improve adherence and reduce alcohol use among HIV+ individuals who report hazardous drinking. | ||||
| Method / Issue: HIV+ participants were recruited from a variety of sources and venues. Eligible participants were randomly assigned to either an 8-session behavioral intervention (based on principles of Motivational Interviewing and Cognitive Behavioral Skills Therapy) or to a time- and content-matched attention control (8-sessions of adherence- and alcohol-related education). Participants were 130 HIV+ men and women who were taking HAART regimens and reported hazardous drinking (>16 drinks/week for men; > 12 drinks/week for women). Adherence was measured through self-report measures, as well as via virologic (viral load), and immunologic (CD4 count) indicators assessed at baseline and 3-months. | ||||
| Results / Comments: Compared to participants in the education condition, intervention participants demonstrated significant decreases in viral load (mean difference = .6 log, p < .02) and significant increases in CD4 cell counts (mean difference = 705, p < .02) at their 3-month follow-up visit. Compared to individuals in the education condition, intervention participants were significantly more likely to demonstrate both a 0.5 log reduction in viral load (OR = 2.7, p = .02) and a 1.0 log reduction in viral load (OR = 2.7, p = .03) at 3-month follow-up. Compared to individuals in the education condition, intervention participants were significantly more likely to demonstrate a 10% or greater increase in CD4 count at 3-month follow-up (OR = 3.4, p = .013). In addition, intervention participants reported significantly greater improvement in both dose adherence (i.e. percent doses taken on time in past 14 days; 15% increase vs. 4%, p < .05) and day adherence (i.e. percent days with perfect adherence; 18% increase vs. 7%, p < .05), compared to those in the education condition. | ||||
| Discussion: An 8-session behavioral intervention can result in improvement in both self-report and biological markers of treatment adherence and disease progression. This type of intervention should be considered for dissemination and integration into HIV clinics providing comprehensive care for HIV+ persons with alcohol problems. | ||||
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