Improving adherence to HAART in HIV

描述(由申请人提供)：本申请是一份申请 指导以患者为导向的研究事业奖(K23)，为罗伯特·保罗博士提供必要的培训和专业知识，以调查治疗结果 感染人类免疫缺陷病毒(HIV)的患者。培训将是 通过密集的教学和实践研究经验获得 通过与Timothy Flanigan博士(赞助商)和Charles博士合作 卡彭特、布拉德福德·纳维亚、查尔斯·辛金和罗纳德·科恩。申请者将会 还参加与艾滋病中心有关的培训机会 基于Miriam医院/Brown Medical的研究和T32培训计划 学校。艾滋病毒感染的基础和临床免疫学培训，测量 忠诚度和与忠诚度相关的心理社会变量， 统计/研究方法，以及艾滋病毒感染的认知后遗症 通过课程作业、定向阅读和完成研究获得 学习。研究部分将审查补偿性措施的效力。 支持坚持艾滋病毒治疗的战略。共有125名艾滋病毒阳性者 将招募个人，并将在 四周的基准期。免疫状况、心理社会变量 与行为改变有关，认知功能将在 基线。然后，参与者将被随机分成两种治疗方法之一 手臂。其中一组将接受标准临床护理(SC)。第二组将 接受标准护理和预先编程的手表，将提供 助记符(MA)，便于HAART给药。遵守程度将使用以下指标进行衡量 电子监控和药片计数。免疫状态，心理社会 变量、认知功能和坚持性将在六年后重新进行检查 几个月后，在审判结束后一个月又一次。分析将确定 MA支持坚持HAART的有效性。回归分析将 以确定遵守的程度与 CD4/CD8细胞计数、血浆病毒载量和认知功能。两国关系 与行为改变和坚持意志相关的心理社会因素之间 在两个治疗组都进行检查。这一结果将提供重要的 对艾滋病毒患者的临床护理的见解。这项研究还将 为申请者提供应用所获得的研究技能的机会 在该奖项的整个培训期间。

DESCRIPTION (provided by applicant): This application is a request for a Mentored Patient-Oriented Research Career Award (K23) to provide Dr. Robert Paul the requisite training and expertise to investigate treatment outcome in patients infected with human immunodeficiency virus (HIV). Training will be obtained through intensive didactic and hands-on research experiences available through collaboration with Dr. Timothy Flanigan (sponsor), and Drs. Charles Carpenter, Bradford Navia, Charles Hinkin, and Ronald Cohen. The applicant will also participate in training opportunities associated with the Center for AIDS Research and T32 Training Programs based at Miriam Hospital/Brown Medical School. Training in basic and clinical immunology of HIV infection, measurement of adherence and psychosocial variables associated with adherence, statistics/research methods, and cognitive sequelae of HIV infection will be obtained through coursework, directed readings, and completion of the research study. The research component will examine the efficacy of a compensatory strategy to support adherence to HIV treatment. A total of 125 HIV-positive individuals will be recruited and adherence will be monitored during a four-week baseline period. Immunological status, psychosocial variables associated with behavior change, and cognitive function will be examined at baseline. The participants will then be randomized into one of two treatment arms. One group will receive standard clinical care (SC). The second group will receive standard care and a pre-programmed wristwatch that will deliver a mnemonic aid (MA) to facilitate HAART dosing. Adherence will be measured using electronic monitoring and pill count. Immunological status, psychosocial variables, cognitive function, and adherence will be re-examined after six months and again one month after the end of the trial. Analyses will determine the efficacy of the MA to support adherence to HAART. Regression analyses will be conducted to determine the degree to which adherence is associated with CD4/CD8 cell count, plasma viral load, and cognitive function. The relationship between psychosocial factors associated with behavior change and adherence will be examined in both treatment groups. The results will provide important insights regarding the clinical care of patients with HIV. The study will also provide the applicant the opportunity to implement research skills obtained throughout the training period of the award.