“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.
• 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.
  
  
• Subjects:
  Adult Computers Counseling Disease Transmission, Infectious Female HIV-1 HIV Infections Humans Longitudinal Studies Middle Aged Risk Management Software Telemedicine Viral Load

  More +
• Keywords:
  Antiretroviral Adherence Computerized Counseling HIV Prevention With Positives Viral Load
• 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
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c738a19ff03968b014c6fa8ba396e141ea21cf1e05a817443ef8013bcf9c8066
• Download URL:
  https://stacks.cdc.gov/view/cdc/29937/cdc_29937_DS1.pdf
• File Type:
  [PDF - 898.35 KB ]