A pilot study of the effects of a behavioural intervention on treatment adherence in HIV-infected patients.

A pilot study was carried out in a group of six HIV-infected non-adherent men testing the effects of a behavioural medication management intervention on adherence with antiretroviral drugs. The study was prospective, using a one-group repeated-measures design. Adherence was measured using two self-reports. The intervention was a behaviourally-based programme that lasted for three months and included individualized education about antiretroviral medication and their side effects; positive reinforcement and encouragement; individualized counselling weekly; follow-up calls; and lifestyle assessment and the identification of adherence barriers. Assessments were carried out at recruitment, immediately after the initiation of the intervention, one month, three months and six months later. Results suggested that the intervention enhanced adherence rates from a mean percentage of 80.27 at baseline to a mean of 97.5% at the end of follow-up (six months time point). Similar improvement was observed in the scores of the scale measuring adherence difficulties. Further, CD4+ counts also slightly improved. Interviews with four of the participants at the end of the study highlighted the problems experienced by patients in taking their medication and supported the usefulness of the intervention. Because of the complexity of the factors behind adherence, it is important that patients are supported with individualized medication management programmes.