The investigators proposed to utilize the best strategies from prior adherence and behavior change research to develop and intervention trial that will evaluate 144 HIV-infected men and women having difficulty adhering to their antiretroviral regimen, who will be randomly assigned to one of two conditions: a tailored behavioral group intervention facilitated by behavioral psychologist and a nurse practitioner which includes social support and patient education, or a standard care condition. The protocol involves an extensive intervention, so relapse prevention is thought to be needed for long term adherence, thus the intervention consists of five sessions initially and four booster sessions subsequently. All participants will be assessed at pre/post- intervention time points at three, nine, fifteen, and twenty-one months.
The aims of the study are: (1) to determine whether tailored behavioral intervention that includes social support and patient intervention components, and maintenance booster sessions, promotes medication adherence, and affective problem solving related to medication compliance among HIV positive individuals over long term follow-up; (2) to determine the level of adherence that is maintained over time in the intervention group; (3) to determine if improvement in medication adherence is associated with less evidence of emotional and behavioral distress, and better quality of life; (4) to explore how medication adherence is associated with sexual transmission risk behaviors; and (5) to explore relationships between medication adherence and potential moderating and mediating variables, including self-efficacy and outcome acceptances related to adherence, behavioral intentions, coping methods, and health care satisfaction.
|Murphy, D A; Marelich, W D; Hoffman, D et al. (2004) Predictors of antiretroviral adherence. AIDS Care 16:471-84|
|Marelich, W D; Murphy, D A (2003) Effects of empowerment among HIV-positive women on the patient-provider relationship. AIDS Care 15:475-81|
|Murphy, D A; Roberts, K Johnston; Hoffman, D et al. (2003) Barriers and successful strategies to antiretroviral adherence among HIV-infected monolingual Spanish-speaking patients. AIDS Care 15:217-30|
|Marelich, W D; Johnston Roberts, K; Murphy, D A et al. (2002) HIV/AIDS patient involvement in antiretroviral treatment decisions. AIDS Care 14:17-26|
|Murphy, D A; Roberts, K J; Martin, D J et al. (2000) Barriers to antiretroviral adherence among HIV-infected adults. AIDS Patient Care STDS 14:47-58|