Individualised Motivational Counselling to Enhance Adherence to Antiretroviral Therapy is not Superior to Didactic Counselling in South African Patients: Findings of the CAPRISA 058 Randomised Controlled Trial
| Autor: | Kogieleum Naidoo, Alison D. Grant, Salim S. Abdool Karim, Santhanalakshmi Gengiah, Tanuja N. Gengiah, Marita Murrman, Katherine Fielding, Francois van Loggerenberg |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Community-Based Participatory Research medicine.medical_specialty Social Psychology Anti-HIV Agents Motivational interviewing Directive Counseling HIV Infections Community Networks Article Medication Adherence law.invention South Africa Social support Randomized controlled trial law Humans Medicine business.industry Public health Public Health Environmental and Occupational Health Social Support Viral Load Confidence interval CD4 Lymphocyte Count 3. Good health Health psychology Treatment Outcome Infectious Diseases Relative risk Physical therapy Female business Viral load |
| Zdroj: | AIDS and Behavior. 19:145-156 |
| ISSN: | 1573-3254 1090-7165 |
| Popis: | Concerns that standard didactic adherence counselling may be inadequate to maximise antiretroviral therapy (ART) adherence led us to evaluate more intensive individualised motivational adherence counselling. We randomised 297 HIV-positive ART-naive patients in Durban, South Africa, to receive either didactic counselling, prior to ART initiation (n = 150), or an intensive motivational adherence intervention after initiating ART (n = 147). Study arms were similar for age (mean 35.8 years), sex (43.1 % male), CD4+ cell count (median 121.5 cells/μl) and viral load (median 119,000 copies/ml). Virologic suppression at 9 months was achieved in 89.8 % of didactic and 87.9 % of motivational counselling participants (risk ratio [RR] 0.98, 95 % confidence interval [CI] 0.90-1.07, p = 0.62). 82.9 % of didactic and 79.5 % of motivational counselling participants achieved >95 % adherence by pill count at 6 months (RR 0.96, 95 % CI 0.85-1.09, p = 0.51). Participants receiving intensive motivational counselling did not achieve higher treatment adherence or virological suppression than those receiving routinely provided didactic adherence counselling. These data are reassuring that less resource intensive didactic counselling was adequate for excellent treatment outcomes in this setting. |
| Databáze: | OpenAIRE |
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