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Pilot testing of an HIV medication adherence intervention in a public clinic in the Deep South.

Konkle-Parker DJ, Erlen JA, Dubbert PM, May W. Pilot testing of an HIV medication adherence intervention in a public clinic in the Deep South. Journal of The American Academy of Nurse Practitioners. 2012 Aug 1; 24(8):488-98.

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PURPOSE: Strict adherence to HIV medications is critical to ensure long-term disease control, and adherence interventions that are possible in a clinic setting with limited resources are needed. DATA SOURCES: This randomized controlled pilot study tested an adherence intervention guided by the Information-Motivation-Behavioral Skills (IMB) model. The intervention included HIV education, a peer video, motivational interviewing, and attention to behavioral skills including communication with providers and adherence-enhancing devices. Dependent variables included 3-4 week adherence recall, medication refill rate, changes in IMB subscale scores, appointment attendance, and HIV-associated laboratory findings. Seventy-three individuals starting or restarting antiretroviral therapy were enrolled and 56 were randomized. CONCLUSIONS: Improvements were seen in most outcomes, with small to moderate effect sizes, but the study was not powered to show statistical significance. Threats to power included a 51% attrition rate, resulting mostly from loss to clinical care or prolonged gaps in care. IMPLICATIONS FOR PRACTICE: A telephone-based intervention to improve HIV medication adherence shows promise. Further study is needed with greater attention to retention in care.

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