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“Computerized Counseling Reduces HIV-1 Viral Load and Sexual Transmission Risk: Findings from a Randomized Controlled Trial”
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Apr 15 2014
Source: J Acquir Immune Defic Syndr. 65(5):611-620. -
Alternative Title:J Acquir Immune Defic Syndr
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Description:Objective
Evaluate a computerized intervention supporting antiretroviral therapy (ART) adherence and HIV transmission prevention.
Design
Longitudinal RCT.
Settings
An academic HIV clinic and a community-based organization in Seattle.
Subjects
240 HIV-positive adults on ART; 209 completed nine-month follow-up (87% retention).
Intervention
Randomization to computerized counseling or assessment-only, 4 sessions over 9 months.
Main Outcome Measures
HIV-1 viral suppression, and self-reported ART adherence, and transmission risks, compared using generalized estimating equations.
Results
Overall, intervention participants had reduced viral load (VL): mean 0.17 log10 decline, versus 0.13 increase in controls, p = 0.053, and significant difference in ART adherence baseline to 9 months (p = 0.046). Their sexual transmission risk behaviors decreased (OR = 0.55, p = 0.020), a reduction not seen among controls (OR = 1.1, p = 0.664), and a significant difference in change (p = 0.040).
Conclusions
Computerized counseling is promising for integrated ART adherence and safer sex, especially for individuals with problems in these areas. This is the first intervention to report improved ART adherence, viral suppression, and reduced secondary sexual transmission risk behavior.
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