Effects of a behavioral intervention on antiretroviral medication adherence among people living with HIV - The healthy living project randomized controlled study
Effects of a behavioral intervention on antiretroviral medication adherence among people living with HIV - The healthy living project randomized controlled study
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DOI：
10.1097/qai.0b013e318158a474
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发表时间：
2007-12-15
影响因子：
3.6
通讯作者：
Chesney, Margaret A.
中科院分区：
文献类型：
--
作者：
Johnson, Mallory O.;Charlebois, Edwin;Chesney, Margaret A.
目的：检验为期15次的个体认知行为干预对抗逆转录病毒（ART）药物依从性的影响。
设计：一项多地点、两组、随机对照试验。
参与者：从总共3818名筛选参与者中，选取204名自我报告ART依从性<85%的HIV感染者随机纳入试验。主要试验的潜在参与者是根据洛杉矶、密尔沃基、纽约和旧金山的性风险标准招募的。
干预：干预的主要结果是减少HIV传播风险行为。15次90分钟的个体干预课程分为3个模块：压力、应对和调整；更安全的行为；以及健康行为，包括强调ART依从性。对照组在试验完成前不接受干预。两组在随机分组后的5、10、15、20和25个月都完成了随访评估。
主要结果测量指标：通过3天计算机化评估测量的自我报告的ART依从性。
结果：在第5个月和第15个月时，干预组和对照组参与者报告的依从率存在显著差异，这分别对应于压力、应对和调整模块之后（5个月时间点）以及健康行为模块之后（15个月时间点）的评估。与对照组相比，干预组的相对改善在随访时消失。
结论：认知行为干预方案可能有效提高ART依从性，但干预效果可能是短暂的。
Objective: To examine the effect of a 15-session individually delivered cognitive behavioral intervention on anfiretroviral (ART) medication adherence.Design: A multisite, 2-group, randomized controlled trial.Participants: Two hundred four HIV-infected participants with selfreported ART adherence < 85% from a total of 3818 participants screened were randomized into the trial. Potential participants were recruited for the main trial based on sexual risk criteria in Los Angeles, Milwaukee, New York, and San Francisco.Intervention: The primary outcome of the intervention was a reduction in HIV transmission risk behaviors. Fifteen 90-minute individually delivered sessions were divided into 3 modules: Stress, Coping, and Adjustment; Safer Behaviors; and Health Behaviors, including an emphasis on ART adherence. Controls received no intervention until trial completion. Both groups completed follow-up assessments at 5, 10, 15, 20, and 25 months after randomization.Main Outcome Measure: Self-reported ART adherence as measured by 3-day computerized assessment.Results: A significance difference in rates of reported adherence was observed between intervention and control participants at months 5 and 15, corresponding to the assessments after the Stress, Coping, and Adjustment module (5-month time point) and after the Health Behaviors module (15-month time point). The relative improvements among the intervention group compared with the control group dissipated at follow-up.Conclusions: Cognitive behavioral intervention programs may effectively improve ART adherence, but the effects of intervention may be short-lived.