Preventing Medication Nonadherence of Youth (13–24 Years) With HIV Initiating Antiretroviral Therapy

Lisa M. Ingerski*, Bethany Means, Fang Wang, Hui Zhang, Nehali Patel, Aditya H. Gaur, Megan L. Wilkins

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Purpose: The objective of this study was to evaluate the feasibility and acceptability of a dynamic, behavioral intervention to optimize medication adherence of adolescents and young adults (AYAs) with HIV newly initiating highly active antiretroviral therapy (HAART) and explore its efficacy on adherence and disease outcomes. Methods: The two-arm randomized controlled trial piloted a brief, individualized intervention designed for direct integration into standard clinical care. In total, 32 AYAs with a confirmed HIV diagnosis, reportedly horizontally acquired, and recommended to initiate HAART completed a two-week placebo trial before HAART initiation and were subsequently randomized to standard of care or the individualized intervention. Adherence and disease outcomes were measured over the first six months of HAART. Results: Results supported the primary study aim regarding feasibility (recruitment = 89%, attendance = 81%–100%, intervention exercise completion = 100%) and acceptability (average favorable response = 89%). Data also supported the positive effect of the intervention on select HAART adherence measures and disease outcomes. Adherence (by pharmacy refill) declined in both groups; however, adherence declined more slowly in the intervention group versus standard of care (p < .001). In addition, 100% of participants receiving the intervention obtained an undetectable viral load by 3 months and maintained an undetectable viral load at 6 months (vs. 68.8% standard of care). Conclusions: This is one of the first interventions to target adherence for AYAs with HIV newly initiating HAART and designed for delivery in existing clinical care settings. Future research will help confirm efficacy and the potential utility of the intervention in promoting HAART adherence from medication initiation and preventing the decrease in adherence often observed over time.

Original languageEnglish (US)
Pages (from-to)644-652
Number of pages9
JournalJournal of Adolescent Health
Volume69
Issue number4
DOIs
StatePublished - Oct 2021

Funding

We thank the adolescents and young adults for their participation and the interventionists and clinic staff who ensured this study's completion. Preliminary data presented at the Society of Pediatric Psychology Annual Conference, Portland, OR, March 2017.

Keywords

  • Horizontally acquired HIV
  • Intervention
  • Medication adherence

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health
  • Pediatrics, Perinatology, and Child Health

Fingerprint

Dive into the research topics of 'Preventing Medication Nonadherence of Youth (13–24 Years) With HIV Initiating Antiretroviral Therapy'. Together they form a unique fingerprint.

Cite this