Effects of a brief video intervention on treatment initiation and adherence among patients attending human immunodeficiency virus treatment clinics

Mary Spink Neumann, Aaron Plant, Andrew D Margolis, Craig B Borkowf, C Kevin Malotte, Cornelis A Rietmeijer, Stephen A Flores, Lydia O'Donnell, Susan Robilotto, Athi Myint-U, Jorge A Montoya, Marjan Javanbakht, Jeffrey D Klausner, Mary Spink Neumann, Aaron Plant, Andrew D Margolis, Craig B Borkowf, C Kevin Malotte, Cornelis A Rietmeijer, Stephen A Flores, Lydia O'Donnell, Susan Robilotto, Athi Myint-U, Jorge A Montoya, Marjan Javanbakht, Jeffrey D Klausner

Abstract

Background: Persons with human immunodeficiency virus (HIV) who get and keep a suppressed viral load are unlikely to transmit HIV. Simple, practical interventions to help achieve HIV viral suppression that are easy and inexpensive to administer in clinical settings are needed. We evaluated whether a brief video containing HIV-related health messages targeted to all patients in the waiting room improved treatment initiation, medication adherence, and retention in care.

Methods and findings: In a quasi-experimental trial all patients (N = 2,023) attending two HIV clinics from June 2016 to March 2017 were exposed to a theory-based, 29-minute video depicting persons overcoming barriers to starting treatment, taking medication as prescribed, and keeping medical appointments. New prescriptions at index visit, HIV viral load test results, and dates of return visits were collected through review of medical records for all patients during the 10 months that the video was shown. Those data were compared with the same variables collected for all patients (N = 1,979) visiting the clinics during the prior 10 months (August 2015 to May 2016). Among patients exposed to the video, there was an overall 10.4 percentage point increase in patients prescribed treatment (60.3% to 70.7%, p< 0.01). Additionally, there was an overall 6.0 percentage point improvement in viral suppression (56.7% to 62.7%, p< 0.01), however mixed results between sites was observed. There was not a significant change in rates of return visits (77.5% to 78.8%). A study limitation is that, due to the lack of randomization, the findings may be subject to bias and secular trends.

Conclusions: Showing a brief treatment-focused video in HIV clinic waiting rooms can be effective at improving treatment initiation and may help patients achieve viral suppression. This feasible, low resource-reliant video intervention may be appropriate for adoption by other clinics treating persons with HIV.

Trial registration: http://www.ClinicalTrials.gov (NCT03508310).

Conflict of interest statement

Two authors are employees of the commercial company, Sentient Research (AP and JAM), and had roles in study design, data collection, and preparation of the manuscript. This commercial affiliation does not alter our adherence to all PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Flow diagram of Taking Care…
Fig 1. Flow diagram of Taking Care of Me study subjects, August 1, 2015 –March 31, 2017.
*The 10-month study period for August 1, 2015 to May 31, 2016 was the historical comparison condition. The 10-month study period from June 1, 2016 to March 31, 2017 was the intervention condition where all patients attending two HIV clinics were exposed to the Taking Care of Me video.

References

    1. INSIGHT START Study Group. Lundgren JD, Babiker AG, Gordin F, Emery S, Grund B, et al. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med. 2015;373(9): 795–807. 10.1056/NEJMoa1506816 .
    1. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6): 493–505. 10.1056/NEJMoa1105243
    1. Günthard HF, Saag MS, Benson CA, del Rio C, Eron JJ, Gallant JE, et al. Antiretroviral drugs for treatment and prevention of HIV Infection in adults: 2016 recommendations of the International Antiviral Society-USA Panel. JAMA. 2016;316(2): 191–210. 10.1001/jama.2016.8900 .
    1. World Health Organization. Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations—2016 Update. 2016. Available from: .
    1. Office of National AIDS Policy. National HIV/AIDS Strategy for the United States—Updated to 2020. 2015. Available from: .
    1. Centers for Disease Control and Prevention. More People with HIV Have the Virus Under Control—Press Release. 2017. Available from: .
    1. Centers for Disease Control and Prevention. Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. Website. 2017. Available from:
    1. Centers for Disease Control and Prevention. High-Impact HIV Prevention, CDC’s Approach to Reducing HIV Infections in the United States. August 2011. Available from:
    1. Besera GT, Cox S, Malotte CK, Rietmeijer CA, Klausner JD, O’Donnell L, et al. Assessing patient exposure to a video-based intervention in STD clinic waiting rooms. Health Promotion Practice. 2016:17(5): 731–738. 10.1177/1524839916631537 .
    1. Neumann MS, O'Donnell L, Doval AS, Schillinger J, Blank S, Ortiz-Rios E, et al. Effectiveness of the VOICES/VOCES sexually transmitted disease/human immunodeficiency virus prevention intervention when administered by health department staff: does it work in the "real world"? Sex Transm Dis. 2011;38(2): 133–139. 10.1097/OLQ.0b013e3181f0c051 .
    1. O’Donnell CR, O’Donnell L, San Doval A, Duran R, Labes K. Reductions in STD infections subsequent to an STD clinic visit. Using video-based patient education to supplement provider interactions. Sex Transm Dis. 1998;25(3): 161–168. PubMed .
    1. Sweat M, O'Donnell C, O'Donnell L. Cost-effectiveness of a brief video-based HIV intervention for African American and Latino sexually transmitted disease clinic clients. AIDS. 2001;15(6): 781–787. PubMed .
    1. Warner L, Klausner JD, Rietmeijer CA, Malotte CK, O’Donnell L, Margolis AD, et al. Effect of a brief video intervention on incident infection among patients attending sexually transmitted disease clinics. PLoS Medicine. 2008;5(6): 919–27. 10.1371/journal.pmed.0050135 .
    1. Gift TL, OʼDonnell LN, Rietmeijer CA, Malotte KC, Klausner JD, Margolis AD, et al. The program cost of a brief video intervention shown in sexually transmitted disease clinic waiting rooms. Sex Transm Dis. 2016;43(1): 61–64. 10.1097/OLQ.0000000000000388 .
    1. Carey MP, Senn TE, Walsh JL, Coury-Doniger P, Urban MA, Fortune T, et al. Evaluating a brief, video-based sexual risk reduction intervention and assessment reactivity with STI clinic patients: Results from a randomized controlled trial. AIDS Behav. 2015:19(7): 1228–1246. 10.1007/s10461-014-0960-3 .
    1. Myint U A, Bull S, Greenwood GL, Patterson J, Rietmeijer CA, Vrungos S, et al. Safe in the City: developing an effective video-based intervention for STD clinic waiting rooms. Health Promot Pract 2010;11(3): 408–417. 10.1177/1524839908318830 .
    1. Health Resources and Services Administration. Ryan White HIV/AIDS Program Annual Client-Level Data Report 2015. Published December 2016. Available from: .
    1. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. 2017. Department of Health and Human Services. Available from: .
    1. Harshbarger CL, O’Donnell LN, Warner L, Margolis AD, Richardson DB, Novey SR, et al. Safe in the City: effective prevention interventions for human immunodeficiency virus and sexually transmitted infections. Am J Prev Med. 2012;42(5): 468–472. 10.1016/j.amepre.2012.01.029 .
    1. Neumann MS, Plant A, Margolis AD, Borkowf CB. Taking Care of Me: Educating and empowering persons living with HIV. Presentation at American Public Health Association’s Global Film Festival, Atlanta, GA, November 7, 2017.
    1. Harshbarger C, Simmons G, Coelho H, Sloop K, Collins C. An empirical assessment of implementation, adaptation, and tailoring: the evaluation of CDC's National Diffusion of VOICES/VOCES. AIDS Educ Prev. 2006;18(4 Suppl A): 184–97. 10.1521/aeap.2006.18.supp.184 .

Source: PubMed

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