“Computerized Counseling Reduces HIV-1 Viral Load and Sexual Transmission Risk: Findings from a Randomized Controlled Trial”

Details

• Alternative Title:
  J Acquir Immune Defic Syndr
• Personal Author:
  KURTH, Ann E. ; SPIELBERG, Freya ; CLELAND, Charles M. ; LAMBDIN, Barrot ; BANGSBERG, David R. ; FRICK, Pamela A. ; SEVERYNEN, Anneleen O. ; CLAUSEN, Marc ; NORMAN, Robert G. ; LOCKHART, David ; SIMONI, Jane M. ; HOLMES, King K.
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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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• Subjects:
  • Adult
  • Computers
  • Counseling
  • Disease Transmission, Infectious
  • Female
  • HIV Infections
  • HIV-1
  • Humans
  • Longitudinal Studies
  • Middle Aged
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• Keywords:
  • HIV
  • computerized counseling
  • prevention with positives
  • viral load
  • antiretroviral adherence
• Source:
  J Acquir Immune Defic Syndr. 65(5):611-620
• Pubmed ID:
  24384803
• Pubmed Central ID:
  PMC3999203
• Document Type:
  Journal Article
• Funding:
  K01 PS000066/PS/NCHHSTP CDC HHSUnited States/ ; K24 MH093243/MH/NIMH NIH HHSUnited States/ ; P30 AI027757/AI/NIAID NIH HHSUnited States/ ; 5 K01 PS000066/PS/NCHHSTP CDC HHSUnited States/
• Volume:
  65
• Issue:
  5
• Download URL:
  https://stacks.cdc.gov/view/cdc/29937/cdc_29937_DS1.pdf
• File Type:
  [PDF - 898.35 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c738a19ff03968b014c6fa8ba396e141ea21cf1e05a817443ef8013bcf9c8066