Individualised Motivational Counselling to Enhance Adherence to Antiretroviral Therapy is not Superior to Didactic Counselling in South African Patients: Findings of the CAPRISA 058 Randomised Controlled Trial

Loggerenberg, Francois van; Grant, Alison D.; Naidoo, Kogieleum; Murrman, Marita; Gengiah, Santhanalakshmi; Gengiah, Tanuja N.; Fielding, Katherine; Karim, Salim Safurdeen. Abdool

doi:10.1007/s10461-014-0763-6

Cited by 19 publications

(15 citation statements)

References 32 publications

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“…9–31,93 Two of the studies reported mortality as an outcome, 9,10 22 reported morbidity, 9–30 1 on retention in care, 19 2 on quality of life, 15,20 and 1 on prevention of HIV transmission, 31 with some studies reporting on multiple outcomes. One article included information on the costs associated with providing adherence counseling and support.…”

Section: Resultsmentioning

confidence: 99%

Integrating Prevention Interventions for People Living With HIV Into Care and Treatment Programs

Medley

Bachanas

Grillo

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Introduction This review assesses the impact of prevention interventions for people living with HIV on HIV-related mortality, morbidity, retention in care, quality of life, and prevention of ongoing HIV transmission in resource-limited settings (RLSs). Methods We conducted a systematic review of studies reporting the results of prevention interventions for people living with HIV in RLS published between January 2000 and August 2014. Standardized methods of searching and data abstraction were used. Results Ninety-two studies met the eligibility criteria: 24 articles related to adherence counseling and support, 13 on risk reduction education and condom provision, 19 on partner HIV testing and counseling, 14 on provision of family planning services, and 22 on assessment and treatment of other sexually transmitted infections. Findings indicate good evidence that adherence counseling and sexually transmitted infection treatment can have a high impact on morbidity, whereas risk reduction education, partner HIV testing and counseling, and family planning counseling can prevent transmission of HIV. More limited evidence was found to support the impact of these interventions on retention in care and quality of life. Most studies did not report cost information, making it difficult to draw conclusions about the cost-effectiveness of these interventions. Conclusions This evidence suggests that these prevention interventions, if brought to sufficient scale and coverage, can help support and optimize the impact of core treatment and prevention interventions in RLS. Further operational research with more rigorous study designs, and ideally with biomarkers and costing information, is needed to determine the best model for providing these interventions in RLS.

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Section: Resultsmentioning

confidence: 99%

Integrating Prevention Interventions for People Living With HIV Into Care and Treatment Programs

Medley

Bachanas

Grillo

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…Study designs were of variable quality and generally showed mixed or positive results for well-being and depressive symptoms indicators. In the literature, psychosocial support interventions were primarily designed and evaluated with regard to instrumental outcomes, such as care engagement (Wanyenze et al, 2011), medication adherence (Cook, Carrington, Schmiege, Starr, & Reeder, 2015;van Loggerenberg et al, 2015), sexual risk reduction (Echenique et al, 2013;Klein et al, 2013;Morin et al, 2007;Wingood et al, 2004), and disclosure (Mundell et al, 2011). No studies measured SRH decision-making.…”

Section: Discussionmentioning

confidence: 99%

Non-specialist psychosocial support interventions for women living with HIV: A systematic review

et al. 2017

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Many women living with HIV experience a range of physical, social, and psychological challenges linked to their HIV status. Psychosocial support interventions may help women cope with these challenges and may allow women to make better decisions around their sexual and reproductive health (SRH), yet no reviews have summarized the evidence for the impact of such interventions on well-being and SRH decision-making among women living with HIV. We systematically reviewed the evidence for non-specialist delivered psychosocial support interventions for women living with HIV, which are particularly relevant in low-resource settings. Outcomes of interest included mental, emotional, social well-being and/or quality of life, common mental health disorders, and SRH decision-making. Searching was conducted through four electronic databases and secondary reference screening. Systematic methods were used for screening and data abstraction. Nine articles met the inclusion criteria, showing positive or mixed results for well-being and depressive symptoms indicators. No studies reported on SRH decision-making outcomes. The available evidence suggests that psychosocial support interventions may improve self-esteem, coping and social support, and reduce depression, stress, and perceived stigma. However, evidence is mixed. Most studies placed greater emphasis on instrumental health outcomes to prevent HIV transmission than on the intrinsic well-being and SRH of women living with HIV. Many interventions included women living with HIV in their design and implementation. More research is required to understand the most effective interventions, and their effect on sexual and reproductive health and rights.

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“…16 The Current Study Data for this qualitative study were collected as part of a randomized control trial (RCT), CAPRISA 058, which aimed to test the efficacy of an individualized motivational counseling intervention to enhance ART adherence. 27 We conducted this RCT in response to concerns that, due a lack of political support for HIV treatment and, more damagingly, explicit support of nutritional supplements, vitamins, and other means of 'treating' HIV, [28][29][30] patients may believe that that ART was no better than these 'treatments' or even poisonous. 31 The majority of our participants were also enrolled on a programme to integrate HIV and tuberculosis (TB) treatment, since active TB is often a common entry point for HIV testing and ART initiation.…”

Section: Introductionmentioning

confidence: 99%

“…In response to these concerns, an enhanced adherence support intervention was developed (described in the parent study 27 ). The primary study showed that the participants who received enhanced adherence support had no greater virological suppression at 9 months than the control arm participants (87.9% vs. 89.8%, p = 0.62).…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Study of Patient Motivation to Adhere to Combination Antiretroviral Therapy in South Africa

Loggerenberg

Gray

Gengiah

et al. 2015

AIDS Patient Care and STDs

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Taken as prescribed, that is, with high adherence, combination antiretroviral therapy (ART) has changed HIV infection and disease from being a sure predictor of death to a manageable chronic illness. Adherence, however, is difficult to achieve and maintain. The CAPRISA 058 study was conducted between 2007 and 2009 to test the efficacy of individualized motivational counselling to enhance ART adherence in South Africa. As part of the overall trial, a qualitative sub-study was conducted, including 30 individual interviews and four focus group discussions with patients in the first 9 months of ART initiation. Data were inductively analyzed, using thematic analysis, to identify themes central to ART adherence in this context. Four themes emerged that characterize the participants' experiences and high motivation to adhere to ART. Participants in this study were highly motivated to adhere, as they acknowledged that ART was 'life-giving', in the face of a large amount of morbidity and mortality. They were further supported by techniques of routine remembering, and highlighted the importance of good social support and access to supportive healthcare workers, to their continued success in negotiating their treatment. Participants in the current study told us that their adherence motivation is enhanced by free accessible care, approachable and supportive healthcare workers, broad social acceptance of ART, and past first-hand experiences with AIDS-related co-morbidity and mortality. Programs that include specific attention to these aspects of care will likely be successful in the long term.

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Individualised Motivational Counselling to Enhance Adherence to Antiretroviral Therapy is not Superior to Didactic Counselling in South African Patients: Findings of the CAPRISA 058 Randomised Controlled Trial

Cited by 19 publications

References 32 publications

Integrating Prevention Interventions for People Living With HIV Into Care and Treatment Programs

Integrating Prevention Interventions for People Living With HIV Into Care and Treatment Programs

Non-specialist psychosocial support interventions for women living with HIV: A systematic review

A Qualitative Study of Patient Motivation to Adhere to Combination Antiretroviral Therapy in South Africa

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