Effectiveness of an Intervention for Improving Treatment Adherence, Service Utilization and Viral Load Among HIV-Positive Adult Alcohol Users

Eaton

JAIDS Journal of Acquired Immune Deficiency Syndromes

2022

Background:Drinking alcohol is a robust predictor of medication nonadherence. In addition to the impact of intoxication on adherence, individuals who believe that it is hazardous to mix medications with alcohol (ie, interactive toxicity beliefs) may forgo taking their medications when drinking. Previous research suggests that alcohol-related intentional nonadherence is a direct result of interactive toxicity beliefs. This study prospectively tested the association between alcohol interactive toxicity beliefs and intentional nonadherence to HIV treatment [ie, antiretroviral therapy (ART)].Methods:Four hundred eight people living with HIV completed comprehensive baseline assessments and 15-month attributions for ART nonadherence.Results:One in 5 participants reported foregoing taking their ART when drinking out of concern for hazardous mixing of alcohol and ART. Poisson regression models predicting the number of months that participants were intentionally nonadherent to ART because they were drinking was predicted by alcohol-ART interactive toxicity beliefs.Conclusions:Beliefs that it is hazardous to drink alcohol when taking medications explains intentional nonadherence and should be directly addressed in adherence improvement interventions for people living with HIV who drink alcohol.

“…4 Reducing alcohol consumption has therefore become a focus of interventions aimed to improve medication adherence, 5 particularly among people living with HIV. 6–9…”

mentioning

confidence: 99%

Believing That It Is Hazardous to Mix Alcohol With Medicines Predicts Intentional Nonadherence to Antiretrovirals

Eaton

JAIDS Journal of Acquired Immune Deficiency Syndromes

2022

PLOS Glob Public Health

“…Regarding the findings, the majority of the RCT and quasi-experimental studies found a significantly bigger improvement in ART adherence in the intervention group [43][44][45][46][47][48][49]. Only…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The majority of the reviewed studies (65%) were qualified as "good" (or "high quality" considering the terminology employed for qualitative studies) [43,44,47,48,[50][51][52][53][54][55][56][57][58][59][60][61][62]. Five studies (21%) were qualified as "fair" [45,46,49,63,64], and only one (4.3%) was qualified as "poor" [65].…”

Section: Plos Global Public Healthmentioning

confidence: 99%

“…Among the good quality studies, five were RCT protocols [54,56,58,62,66], five were pilot and/or feasibility studies [51-53, 57, 61], four were RCT studies [43,44,47,50] and one was a quasi-experimental study [48]. The "high quality" (qualitative) studies [59,60].…”

Section: Plos Global Public Healthmentioning

confidence: 99%

“…Among group support interventions, there were two interventions delivered in a group format [46,47]. One of them [47] consisted of an 8-sessions manualized group therapy led by two trained counselors, and they were focused on risk reduction in drugs using PLWHA. The other was a social media private group composed mainly of young PLWHA and led by an adult LWHA [46].…”

Section: Plos Global Public Healthmentioning

confidence: 99%

See 2 more Smart Citations

Characteristics of psychosocial interventions to improve ART adherence in people living with HIV: A systematic review

Costa-Cordella

Rossi²,

Grasso-Cladera³

et al. 2022

The HIV/AIDS pandemic continues to be a significant global public health crisis. The main HIV/AIDS treatment is the antiretroviral therapy (ART), which is highly effective but depends on the patient’s adherence to be successful. However, the adherence to antiretroviral therapy remains unsatisfactory across different populations, which raises considerable difficulties at both individual and collective levels. Suboptimal adherence to ART can be overcome through multidisciplinary management that includes evidence-based psychosocial interventions. Existing reviews on these interventions have focused mainly on studies with experimental designs, overlooking valuable interventions whose evidence comes from different study designs. Here, we aimed to carry out a comprehensive review of the current research on psychosocial interventions for ART adherence and their characteristics including studies with different designs. We conducted a systematic review following PRISMA guidelines. We searched five databases (Pubmed, EBSCO, LILACS, WoS and SCIELO) for articles reporting a psychosocial intervention to improve treatment adherence for people living with HIV (adults). The quality of each study was analyzed with standardized tools, and data were summarized using a narrative synthesis method. Twenty-three articles were identified for inclusion, and they demonstrated good to fair quality. Individual counseling was the most frequent intervention, followed by SMS reminders, education, and group support. Most interventions combined different strategies and self-efficacy was the most common underlying theoretical framework. This review provides insight into the main characteristics of current psychosocial interventions designed to improve ART treatment adherence. PROSPERO number: CRD42021252449.

Effect of Social Support Interventions on Adherence to Antiretroviral Therapy Among People Living with HIV: A Systematic Review and Meta-Analysis

et al. 2022