Peer support and text reminders lead to only transient improvements in HIV treatment adherence
Interventions to improve adherence to antiretroviral therapy such as peer support and electronic messaging are only partially effective, US investigators report in the online edition of the Journal of Acquired Immune Deficiency Syndromes.
Peer support improved adherence in the short-term, but was not associated with significant changes in either viral load or CD4 cell count, whereas electronic messaging had no effect on reported pill-taking, but did appear to improve laboratory markers.
Antiretroviral treatment can significantly improve the health and life expectancy of HIV-positive people. However, HIV treatment needs to be taken very rigorously and the best results are seen in patients who take all or nearly all of their doses. Many individuals do not achieve such high levels of adherence.
Investigators from Seattle designed a prospective, randomized, controlled trial to see if peer support, electronic messaging, or a combination of the two improved levels of adherence in both the short- and long-term in patients receiving antiretroviral therapy.
Their study ran between 2003 and 2007 and included 224 individuals.
“These findings suggest that receiving informational, emotional, and affirmational support from peers might promote adherence, but that effect did not persist when the support was discontinued. Ongoing social support, perhaps from individuals more integrated into participants’ lives, may hold greater promise in promoting and sustaining long-term adherence”, write the investigators.
They conclude, “Maintaining optimal adherence requires a set of complex and dynamic behaviors that may necessitate interventions of equal sophistication with personnel trained and dedicated to providing them on an ongoing basis.”
Reference
An RCT of peer support and pager messaging to promote antiretroviral therapy adherence and clinical outcomes among adults initiating or modifying therapy in Seattle, WA, United States.
Simoni, Jane M PhD et al
Journal of Acquired Immune Deficiency Syndromes published ahead of print September 23 2009. 10.1097/QAI.0b013e3181b9300c
Link to JAIDS abstract
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