Development and Efficacy of an Intervention to Enhance Readiness for Adherence among Adults Who Had Previously Failed HIV Treatment

Abstract

This paper outlines the development and initial testing of the READY intervention that was designed to enhance readiness for adherence among adults with a history of nonadherence to HIV treatment. Participants in this study were adults (n = 28) who ranged in age from 24 to 57: most were male (75%) and African American (64%). Participants had failed an average of four prior HIV treatment regimens due to nonadherence and were beginning a new regimen of protease inhibitor (PI)-based antiretroviral medications. The study was conducted from 2003 to 2006, prior to the standard use of boosted PI regimens. Results indicated that 50% of participants became adherent and had suppressed viral loads to less than 50 copies per milliliter at the 3-month postintervention follow-up time point. Of those who became adherent, 79% remained adherent at the 12-month postintervention follow-up time point. Implementation of the intervention was found to be feasible in a real-world setting and participants reported that they liked the intervention. A 6-session length of the intervention was found to have the same impact on adherence outcomes as a 12-session length. No differences were found in outcomes with regard to the intervention's start time: before or at the same time the new antiretroviral regimen was initiated. These results suggest that the READY intervention may have merit and that the 6-session length may be more acceptable. However, a larger controlled study is indicated to examine intervention efficacy further.