Adherence Intervention for Incarcerated Persons with HIV

描述(申请人提供)：严格遵守复杂的艾滋病毒药物治疗 养生法对于实现和维持改善的健康结果至关重要。 许多人第一次开始艾滋病毒治疗是在他们进入惩教机构时。 这一点很重要，因为早期治疗依从性是一个强有力的预测 继续坚持。此外，最初的治疗反应不佳 抗逆转录病毒药物可能会降低随后的潜在疗效 抗逆转录病毒疗法。抗逆转录病毒依从性不佳 这些疗法可以迅速导致抗药性病毒株的发展， 从而增加了不良治疗反应的可能性，并提高了 具有抗药性的艾滋病毒毒株后来传播给其他人的可能性。 因此，加强被监禁者对艾滋病毒治疗的坚持 艾滋病毒携带者具有重要的健康和公共卫生益处。这 该项目建议开发和现场测试电话传递的干预措施 提高艾滋病毒携带者对抗逆转录病毒治疗的依从性 在州立监狱系统里。拟议研究的具体目标是： (A)设计和测试电话传递的遵守的可行性 对12名艾滋病毒携带者进行干预；(B)确定 通过对12名受试者进行结构化访谈了解干预措施的可接受性 监狱囚犯和10名在监狱工作的护士、医生和管理人员 环境；以及(C)对112名囚犯进行随机干预研究 艾滋病毒携带者测试电话递送的潜在疗效 实验干预与依从性结果的比较 1个月电话健康教育控制干预 3个月随访积分。没有专门设计的干预措施来 帮助被监禁人口增强动机和技能 自我调节遵守联合抗逆转录病毒方案。因此，a 在取得疗效之前，将开发量身定制的干预措施 测试。在拟议的研究中开发的干预措施将以行为改变的跨理论模型为指导，并将结合动机 具有行为技能培训策略的面试技巧 已被广泛用于改变健康行为。有很大的需求 有效的依从性干预措施和可行的方法 很难接触到艾滋病毒感染人群。开发一种 电话传递的干预旨在提高技能和动力 被监禁的艾滋病毒携带者坚持抗逆转录病毒将有所帮助 解决这一紧迫需求。

DESCRIPTION (provided by applicant): Close adherence to complex HIV medication regimens is critical for achieving and sustaining improved health outcomes. Many persons first begin HIV treatment when they enter a correctional facility. This is important because early treatment adherence is a strong predictor of continued adherence. Moreover, poor treatment responses to initial antiretroviral medications can reduce the potential effectiveness of subsequent antiretroviral regimens. Less than excellent adherence to antiretroviral regimens can quickly lead to the development of drug-resistant viral strains, thereby increasing the likelihood of a poor treatment response and raising the possibility of drug-resistant HIV strains later being transmitted to others. Therefore, enhancing adherence to HIV treatment among incarcerated persons living with HIV carries important health and public health benefits. This project proposes to develop and field test a telephone-delivered intervention to increase adherence to antiretroviral treatment among persons living with HIV in a state prison system. The specific aims of the proposed research are to: (a) design and test the feasibility of a telephone-delivered adherence intervention with 12 incarcerated persons living with HIV; (b) determine the acceptability of the intervention by conducting structured interviews with 12 prison inmates and 10 nurses, physicians, and administrators working in prison settings; and (c) conduct a randomized intervention study with 112 incarcerated persons living with HIV to test the potential efficacy of a telephone-delivered experimental intervention compared to adherence outcomes of a telephone-delivered health education control intervention at 1-month and 3-month follow-up points. There are no interventions specifically designed to assist incarcerated populations in enhancing motivation and skills for self-regulated adherence to combination antiretroviral regimens. Therefore, a tailored intervention will be developed before moving forward with efficacy testing. The intervention developed in the proposed research will be guided by the transtheoretical model of behavior change and will combine motivational interviewing techniques with behavioral skills training strategies that have been widely utilized to change health behavior. There is a great need for effective adherence interventions and feasible methods for delivering them to difficult to reach HIV-infected populations. Development of a telephone-delivered intervention designed to enhance skills and motivation for antiretroviral adherence among incarcerated persons living with HIV will help address this urgent need.