Adherence Intervention for Incarcerated Persons with HIV

描述（由申请人提供）：密切依从复杂的HIV药物治疗 治疗方案对于实现和维持改善的健康成果至关重要。 许多人在进入教养所时才开始艾滋病毒治疗。 这一点很重要，因为早期治疗依从性是一个强有力的预测因素， 继续坚持。此外，初始治疗反应差， 抗逆转录病毒药物可以降低后续治疗的潜在有效性。 抗逆转录病毒疗法。抗逆转录病毒药物依从性不佳 治疗方案可迅速导致耐药病毒株的发展， 从而增加了不良治疗反应的可能性， 耐药的艾滋病毒株后来传播给他人的可能性。 因此，加强被监禁者对艾滋病毒治疗的坚持， 艾滋病毒感染者对健康和公共卫生具有重要的益处。这 项目建议开发和现场测试电话提供的干预措施 提高艾滋病毒感染者坚持抗逆转录病毒治疗的比例 在州监狱系统里拟议研究的具体目标是： (a)设计和测试电话交付的遵守的可行性 对12名感染艾滋病毒的囚犯进行干预;（B）确定 干预的可接受性进行结构化访谈12 监狱囚犯和10名护士、医生和监狱管理人员 （c）对112名被监禁者进行随机干预研究 艾滋病毒感染者测试电话传递的潜在功效， 实验性干预与 1个月时电话健康教育控制干预， 3-个月的跟踪点。没有专门设计的干预措施， 协助被监禁人口增强动力和技能， 自我调节，坚持联合抗逆转录病毒治疗方案。因此 在取得疗效之前，将制定量身定制的干预措施 试验.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，并将联合收割机 面试技巧与行为技能培训策略， 被广泛用于改变健康行为。非常需要 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者。发展 电话提供的干预措施，旨在提高技能和动机， 艾滋病毒感染者的抗逆转录病毒治疗将有助于 满足这一迫切需求。

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.