Increasing Antiretroviral Adherence for HIV-Positive African Americans (Project Rise): A Treatment Education Intervention Protocol

Glenn J Wagner, Laura M Bogart, Matt G Mutchler, Bryce McDavitt, Kieta D Mutepfa, Brian Risley, Glenn J Wagner, Laura M Bogart, Matt G Mutchler, Bryce McDavitt, Kieta D Mutepfa, Brian Risley

Abstract

Background: HIV-positive African Americans have been shown to have lower adherence to antiretroviral therapy (ART) than those of other races/ethnicities, yet adherence interventions have rarely been tailored to the needs of this population.

Objective: We developed and will evaluate a treatment education adherence intervention (called Rise) that was culturally adapted to address the needs of African Americans living with HIV.

Methods: This randomized controlled trial will examine the effects of the Rise intervention on ART adherence and HIV viral load. African Americans on ART who report adherence problems will be recruited from the community and randomly assigned to receive the intervention or usual care for 6 months. The intervention consists of 6-10 individual counseling sessions, with more sessions provided to those who demonstrate lower adherence. Primary outcomes include adherence as monitored continuously with Medication Event Monitoring Systems (MEMS) caps, and viral load data received from the participant's medical provider. Survey assessments will be administered at baseline and month 6.

Results: The trial is ongoing.

Conclusions: If effective, the Rise intervention will provide community-based organizations with an intervention tailored to address the needs of African Americans for promoting optimal ART adherence and HIV clinical outcomes.

Trial registration: Clinicaltrials.gov NCT01350544; https://ichgcp.net/clinical-trials-registry/NCT01350544 (Archived by WebCite at http://www.webcitation.org/6fjqqnmn0).

Keywords: African Americans; HIV; adherence; antiretroviral treatment; intervention; patient compliance; treatment education.

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Conceptual model of Rise, a culturally tailored treatment education program.

References

    1. Giordano TP, White AC, Sajja P, Graviss EA, Arduino RC, Adu-Oppong A, Lahart CJ, Visnegarwala F. Factors associated with the use of highly active antiretroviral therapy in patients newly entering care in an urban clinic. J Acquir Immune Defic Syndr. 2003 Apr 1;32(4):399–405.
    1. Knowlton AR, Hoover DR, Chung SE, Celentano DD, Vlahov D, Latkin CA. Access to medical care and service utilization among injection drug users with HIV/AIDS. Drug Alcohol Depend. 2001 Sep 1;64(1):55–62.
    1. Mugavero MJ, Lin H, Allison JJ, Willig JH, Chang P, Marler M, Raper JL, Schumacher JE, Pisu M, Saag MS. Failure to establish HIV care: Characterizing the "no show" phenomenon. Clin Infect Dis. 2007 Jul 1;45(1):127–130. doi: 10.1086/518587.
    1. Gebo KA, Fleishman JA, Conviser R, Reilly ED, Korthuis PT, Moore RD, Hellinger J, Keiser P, Rubin HR, Crane L, Hellinger FJ, Mathews WC. Racial and gender disparities in receipt of highly active antiretroviral therapy persist in a multistate sample of HIV patients in 2001. J Acquir Immune Defic Syndr. 2005 Jan 1;38(1):96–103.
    1. Shapiro MF, Morton SC, McCaffrey DF, Senterfitt JW, Fleishman JA, Perlman JF, Athey LA, Keesey JW, Goldman DP, Berry SH, Bozzette SA. Variations in the care of HIV-infected adults in the United States: Results from the HIV Cost and Services Utilization Study. JAMA. 1999;281(24):2305–2315.
    1. Simoni JM. Is race/ethnicity associated with ART adherence? Findings from the MACH14 study. 5th International Conference on HIV Treatment Adherence; May 23-25, 2010; Miami, FL. 2010. May 23,
    1. Bogart LM, Bird ST, Walt LC, Delahanty DL, Figler JL. Association of stereotypes about physicians to health care satisfaction, help-seeking behavior, and adherence to treatment. Soc Sci Med. 2004 Mar;58(6):1049–1058.
    1. Mostashari F, Riley E, Selwyn PA, Altice FL. Acceptance and adherence with antiretroviral therapy among HIV-infected women in a correctional facility. J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Aug 1;18(4):341–348.
    1. Weintrob AC, Grandits GA, Agan BK, Ganesan A, Landrum ML, Crum-Cianflone NF, Johnson EN, Ordóñez CE, Wortmann GW, Marconi VC, IDCRP HIV Working Group Virologic response differences between African Americans and European Americans initiating highly active antiretroviral therapy with equal access to care. J Acquir Immune Defic Syndr. 2009 Dec;52(5):574–580. doi: 10.1097/QAI.0b013e3181b98537.
    1. Losina E, Schackman BR, Sadownik SN, Gebo KA, Walensky RP, Chiosi JJ, Weinstein MC, Hicks PL, Aaronson WH, Moore RD, Paltiel AD, Freedberg KA. Racial and sex disparities in life expectancy losses among HIV-infected persons in the United States: Impact of risk behavior, late initiation, and early discontinuation of antiretroviral therapy. Clin Infect Dis. 2009 Nov 15;49(10):1570–1578. doi: 10.1086/644772.
    1. Mugavero MJ, Lin H, Willig JH, Westfall AO, Ulett KB, Routman JS, Abroms S, Raper JL, Saag MS, Allison JJ. Missed visits and mortality among patients establishing initial outpatient HIV treatment. Clin Infect Dis. 2009 Jan 15;48(2):248–256. doi: 10.1086/595705.
    1. Lima VD, Harrigan R, Murray M, Moore DM, Wood E, Hogg RS, Montaner JS. Differential impact of adherence on long-term treatment response among naive HIV-infected individuals. AIDS. 2008 Nov 12;22(17):2371–2380. doi: 10.1097/QAD.0b013e328315cdd3.
    1. Schackman BR, Ribaudo HJ, Krambrink A, Hughes V, Kuritzkes DR, Gulick RM. Racial differences in virologic failure associated with adherence and quality of life on efavirenz-containing regimens for initial HIV therapy: Results of ACTG A5095. J Acquir Immune Defic Syndr. 2007 Dec 15;46(5):547–554.
    1. Bogart L, Wagner G, Galvan F, Trombacco K, Banks D. Conspiracy beliefs about HIV are related to antiretroviral treatment nonadherence among African American men with HIV. J Acquir Immune Defic Syndr. 2010 Apr 01;53(5):648–655. doi: 10.1097/QAI.0b013e3181c57dbc.
    1. Bogart LM, Galvan FH, Wagner GJ, Klein DJ. Longitudinal association of HIV conspiracy beliefs with sexual risk among black males living with HIV. AIDS Behav. 2011 Aug;15(6):1180–1186. doi: 10.1007/s10461-010-9796-7.
    1. McGuire TG, Miranda J. New evidence regarding racial and ethnic disparities in mental health: Policy implications. Health Aff (Millwood) 2008;27(2):393–403. doi: 10.1377/hlthaff.27.2.393.
    1. DeNavas-Walt C, Proctor B, Smith J. U.S. Census Bureau. 2009. [2016-03-04]. Income, Poverty, and Health Insurance Coverage in the United States
    1. Rumptz MH, Tobias C, Rajabiun S, Bradford J, Cabral H, Young R, Cunningham WE. Factors associated with engaging socially marginalized HIV-positive persons in primary care. AIDS Patient Care STDS. 2007;21 Suppl 1:S30–9. doi: 10.1089/apc.2007.9989.
    1. Cunningham WE, Andersen RM, Katz MH, Stein MD, Turner BJ, Crystal S, Zierler S, Kuromiya K, Morton SC, St CP, Bozzette SA, Shapiro MF. The impact of competing subsistence needs and barriers on access to medical care for persons with human immunodeficiency virus receiving care in the United States. Med Care. 1999 Dec;37(12):1270–1281.
    1. Mathes T, Pieper D, Antoine S, Eikermann M. Adherence-enhancing interventions for highly active antiretroviral therapy in HIV-infected patients - a systematic review. HIV Med. 2013 Nov;14(10):583–595. doi: 10.1111/hiv.12051.
    1. Simoni JM, Amico KR, Smith L, Nelson K. Antiretroviral adherence interventions: Translating research findings to the real world clinic. Curr HIV/AIDS Rep. 2010 Feb;7(1):44–51. doi: 10.1007/s11904-009-0037-5.
    1. Amico KR, Harman JJ, Johnson BT. Efficacy of antiretroviral therapy adherence interventions: A research synthesis of trials, 1996 to 2004. J Acquir Immune Defic Syndr. 2006 Mar;41(3):285–297. doi: 10.1097/01.qai.0000197870.99196.ea.
    1. Bogart L, Wagner G, Mutchler M, McDavitt B, McKay T, Risley B. Promotion of treatment adherence engagement in care through treatment advocacy for people with HIV. 4th International IAPAC/NIMH Conference on HIV Treatment Adherence; April 5-7, 2009; Miami FL. 2009. Apr 05,
    1. Mutchler MG, Wagner G, Cowgill BO, McKay T, Risley B, Bogart LM. Improving HIV/AIDS care through treatment advocacy: Going beyond client education to empowerment by facilitating client-provider relationships. AIDS Care. 2011 Jan;23(1):79–90. doi: 10.1080/09540121.2010.496847.
    1. Angelou M. And Still I Rise. New York: Random House; 1978.
    1. Fisher JD, Fisher WA, Amico KR, Harman JJ. An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychol. 2006 Jul;25(4):462–473. doi: 10.1037/0278-6133.25.4.462.
    1. Amico KR, Toro-Alfonso J, Fisher JD. An empirical test of the information, motivation and behavioral skills model of antiretroviral therapy adherence. AIDS Care. 2005 Aug;17(6):661–673. doi: 10.1080/09540120500038058.
    1. Starace F, Massa A, Amico KR, Fisher JD. Adherence to antiretroviral therapy: An empirical test of the information-motivation-behavioral skills model. Health Psychol. 2006 Mar;25(2):153–162. doi: 10.1037/0278-6133.25.2.153.
    1. Kidder DP, Wolitski RJ, Campsmith ML, Nakamura GV. Health status, health care use, medication use, and medication adherence among homeless and housed people living with HIV/AIDS. Am J Public Health. 2007 Dec;97(12):2238–2245. doi: 10.2105/AJPH.2006.090209.
    1. Leaver CA, Bargh G, Dunn JR, Hwang SW. The effects of housing status on health-related outcomes in people living with HIV: A systematic review of the literature. AIDS Behav. 2007 Nov;11(6 Suppl):85–100. doi: 10.1007/s10461-007-9246-3.
    1. Bogart LM, Wagner GJ, Galvan FH, Klein DJ. Longitudinal relationships between antiretroviral treatment adherence and discrimination due to HIV-serostatus, race, and sexual orientation among African-American men with HIV. Ann Behav Med. 2010 Oct;40(2):184–190. doi: 10.1007/s12160-010-9200-x.
    1. Boarts JM, Sledjeski EM, Bogart LM, Delahanty DL. The differential impact of PTSD and depression on HIV disease markers and adherence to HAART in people living with HIV. AIDS Behav. 2006 May;10(3):253–261. doi: 10.1007/s10461-006-9069-7.
    1. Miller W, Rollnick S. Motivational Interviewing: Preparing People for Change. 2nd ed. New York: Guilford Press; 2002.
    1. Rachal N, McDavitt B, Mutchler M, Wagner G, Ghani M, Nogg K, Bogart L. Making the personal connection: Fostering trust to support health behaviors among African Americans living with HIV/AIDS. National African American MSM Leadership Conference on HIV/AIDS and Other Health Disparities; AIDS Education Services for Minorities; January 16-19, 2014; Orlando FL. 2014. Jan 16,
    1. Bangsberg DR, Hecht FM, Charlebois ED, Zolopa AR, Holodniy M, Sheiner L, Bamberger JD, Chesney MA, Moss A. Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population. AIDS. 2000 Mar 10;14(4):357–366.
    1. Bing EG, Bingham T, Millett GA. Research needed to more effectively combat HIV among African-American men who have sex with men. J Natl Med Assoc. 2008 Jan;100(1):52–56.
    1. Mize SJ, Robinson BE, Bockting WO, Scheltema KE. Meta-analysis of the effectiveness of HIV prevention interventions for women. AIDS Care. 2002 Apr;14(2):163–180. doi: 10.1080/09540120220104686.
    1. Logan TK, Cole J, Leukefeld C. Women, sex, and HIV: Social and contextual factors, meta-analysis of published interventions, and implications for practice and research. Psychol Bull. 2002 Nov;128(6):851–885.
    1. Simoni J, Pearson C, Pantalone D, Marks G, Crepatz N. Efficacy of interventions in improving highly active antiretroviral therapy adherence and HIV-1 RNA viral load. J Acquir Immune Defic Syndr. 2006;43(Suppl 1):S23–S35.
    1. Williams JK, Wyatt GE, Wingood G. The four Cs of HIV prevention with African Americans: Crisis, condoms, culture, and community. Curr HIV/AIDS Rep. 2010 Nov;7(4):185–193. doi: 10.1007/s11904-010-0058-0.
    1. Wyatt GE. Enhancing cultural and contextual intervention strategies to reduce HIV/AIDS among African Americans. Am J Public Health. 2009 Nov;99(11):1941–1945. doi: 10.2105/AJPH.2008.152181.

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