Zambia was identified as one of the fourteen focus countries for the President's Emergency Program for HIV/AIDS Relief (PEPFAR) and is scheduled to be awarded up to $57.9 million to provide antiretroviral (ARV) medications to an estimated 865,298 adults and children. A unique opportunity now exists to develop a program of therapeutic alliance among patients and providers to facilitate high levels of adherence to medical regimen. The overall aims of the proposed study are to launch a rapid response to the impending massive influx of ARVs with an intervention to enhance ARV medication adherence among previously drug naive populations in Lusaka, Zambia. Goals of the study are 1) identify patient, provider, illness and contextual factors that influence medication adherence, 2) identify culture specific factors that influence adherence, 3) develop and implement a culturally tailored intervention to enhance adherence, 4) evaluate the effects of a structured adherence intervention on adherence to ARV medications. One hundred and forty HIV+ drug naive individuals will be enrolled and randomly assigned to one of two conditions: Medication Adherence Intervention (MAI) group condition: Led by a trained health practitioner, participants will receive medication information combined with problem solving skills in an experiential/interactive group format. Practitioner Medical Directive (Standard of Care) individual condition: Led by a medical practitioner, participants will receive medication information in an individual format. The long-term objectives of the research program are to learn how Zambian patients adapt to using ARVs consistently, what influences adherence overtime, and to use the MAI to develop and pilot an effective, culturally appropriate intervention for drug naive Zambians that encourages and supports their use of ARVs. The ultimate objective is to apply the results of this research in the healthcare setting as the standard of care. This research is designed to respond the major public health risk for the rapid development of medication-resistant strains of HIV as a consequence of less than stringent adherence. The goals of this research, the development, implementation and evaluation of a culturally tailored method of increasing adherence to ARVs, represent an important strategy for preventing the development and transmission of medication resistant HIV in the sub-Saharan African nation of Zambia. ? ?

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Exploratory/Developmental Grants (R21)
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Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
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Pouliot, Eileen M
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Barry University
Schools of Arts and Sciences
Miami Shores
United States
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Jones, Deborah; Cook, Ryan; Spence, Andrew et al. (2014) Antiretroviral therapy in Zambia: do partners on ART enhance adherence? J Int Assoc Provid AIDS Care 13:497-500
Jones, Deborah L; Zulu, Isaac; Vamos, Szonja et al. (2013) Determinants of engagement in HIV treatment and care among Zambians new to antiretroviral therapy. J Assoc Nurses AIDS Care 24:e1-12