Modifying Facilitators and Barriers to HIV Adherence

  • Bunting, Sheila McGuire (PI)
  • Bunting, Sheila McGuire (PI)

Project: Research project

Project Details


DESCRIPTION (provided by applicant): Adherence to antiretroviral medications is
now a key component to maintaining health for persons living with HIV/AIDS.
However, adherence to antiretroviral medications in HIV disease is a major
challenge because of the numbers and timing of medications and the distressing
side effects. Deviation in time between doses may result in production of
drug-resistant strains of the virus, compromising subsequent therapy for the
patient. Practical valid approaches to enhance adherence to antiretroviral
medications are needed. Previous studies on adherence to medications indicate
that it is a complex phenomenon best addressed by multidimensional
interventions tailored to the individual's schedule and lifestyle. This study
builds upon the principal investigator's previous qualitative studies in which
persons living with HIV described their perceptions of facilitators and
barriers to taking their medication as well as strategies they used to maintain
adherence. From these stories there emerged a theoretical framework "Creating a
New Normal" in which clients' confront the need for medications, mobilize
available resources, and overcome barriers to adherence, thereby integrating
medication adherence into their lives. Based on this framework, we will pilot
test an intervention that assists clients to improve adherence to HIV
medications by creating and mobilizing family and community resources to
overcome barriers and integrate the treatment regimen into their lives.

The setting for the study is an infectious disease clinic in a southeastern
state that provides health services to clients with HIV (over 66 percent are
African Americans and 40 percent are women) from surrounding rural and
semi-rural areas. A randomized two-group (n = 44 per group) factorial design
with repeated measures will test the effect of an intervention consisting of
individualized assessment, education, counseling, and referrals administered by
a research nurse in face-to-face and follow-up telephone sessions over a
3-month period. Adherence to all prescribed medications will be measured at
times 1, 2, and 3, by self-report, and pill counts, and to one antiretroviral
medication by electronic monitor in the container. Information gained from this
study will be used to design a large randomized clinical intervention trial
Effective start/end date6/1/015/31/04


  • Medicine(all)
  • Nursing(all)


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