An Enhanced Adherence Support Programme for Highly Active Antiretroviral Therapy (HAART) (eASP)
In southern Africa, TB is the most common first AIDS-defining condition. Initiating Antiretroviral therapy (ART) in HIV positive TB patients will lead to the inclusion of the majority of HIV/AIDS patients currently fulfilling the criteria for therapy. Establishing an effective intervention to increase treatment adherence in this group is essential for the successful roll out of ART in the region. This proposed randomized controlled study aims to compare the effectiveness of two adherence support programmes (ASP) for use in patients with HIV-related TB in the context of CAPRISA AIDS Treatment (CAT)programme in KwaZulu-Natal, South Africa; the enhanced adherence support programme (E-ASP) or the standard adherence support programme (S-ASP).
S-ASP consists of three counselor presented, group education sessions. E-ASP is an extension of S-ASP and is based on the Information-Motivation-Behavioral Skills (IMB) Model of Adherence to Antiretroviral Therapy, a theoretical model initially developed to reduce HIV risk behavior. The E-ASP will consist of several interconnected components: 1) development and maintenance of an educational and supportive milieu at the CDC Clinic, 2) provision of five structured educational, support and behavioral skills building sessions, and (3) three weekly ART planning sessions.
|HIV Infections||Behavioral: Enhanced adherence support Behavioral: Standard adherence support||Phase 3|
|Study Design:||Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Health Services Research
|Official Title:||An Enhanced Adherence Support Programme for HAART|
- suppressed viral load at 9 months [ Time Frame: 9 months ]Those participants with suppressed viral load at 9 months will be classed as treatment success, all others will be classed as treatment failures for the purposes of this outcome.
- feasibility of E-ASP in this resource constrained setting [ Time Frame: one year ]
- Secondly to describe the relationship between adherence and viral load and CD4+counts [ Time Frame: 2 months, 9 months and 12 months ]
- describe factors associated with poor/good adherence in this group [ Time Frame: one year ]
- describe the relationship between early adherence and adherence at subsequent timepoints [ Time Frame: 2 weeks, and 2 and 9 months after start ART and 12 months ]
- to establish the validity of self-reported adherence (in relation to pill counts) in this context [ Time Frame: one year ]
- to assess the long-term impact of E-ASP on adherence [ Time Frame: 18 months ]
- suppressed viral load at 12 months [ Time Frame: 12 months ]Those participants with suppressed viral load will be classed at treatment successes, all others will be classed as treatment failures for this secondary outcome measure.
- adherence at 6 months [ Time Frame: 6 months ]
|Study Start Date:||August 2007|
|Study Completion Date:||March 2011|
|Primary Completion Date:||March 2010 (Final data collection date for primary outcome measure)|
enhanced adherence support for patients initiating antiretroviral therapy
Behavioral: Enhanced adherence support
The enhanced adherence support intervention consists of 5 one-on-one, Information-Motivation-Behavioral Skills (IMB) theory-based counseling sessions, as well as a problem-solving card which summarizes key messages and strategies. The counseling sessions are given at key points post-initiation of therapy: at baseline, 2 weeks, 2 months, 3 months, and 6 months. Three brief weekly ART planning sessions are conducted post-initiation of therapy.
Active Comparator: 2
standard adherence support
Behavioral: Standard adherence support
The control arm receives the standard of care adherence support which consists of three group counseling adherence sessions conducted prior to initiation of therapy.
Show Detailed Description
Please refer to this study by its ClinicalTrials.gov identifier: NCT00408642
|CAPRISA eThekwini Clinical Research Site|
|Durban, KwaZulu-Natal, South Africa, 4001|
|Principal Investigator:||Francois van Loggerenberg, MA(ResPsych)||CAPRISA, University of KwaZulu-Natal|