A randomized controlled psycho-education intervention trial: Improving psychological readiness for successful HIV medication adherence and reducing depression before initiating HAART

Abstract

The purpose of this study was to evaluate a novel psycho-educational intervention intended to increase patients’ medication preparedness and treatment adherence skills before initiating highly active antiretroviral therapy (HAART). Sixty-three HIV-positive patients not currently on antiretroviral therapy participated in a randomized controlled trial of a standardized, four-session psycho-educational intervention (Supportive Therapy for Adherence to Antiretroviral Treatment; STAART). Session topics included learning techniques to increase medication adherence and learning effective strategies to cope with stress and depression. Patients completed psychological questionnaires assessing psychological readiness to initiate HAART and depressed mood. They completed both measures at study baseline and at four-weeks post-baseline. After controlling for baseline medication readiness scores, intervention patients (n=30) reported significantly higher mean medication readiness following the STAART intervention (four-weeks post-baseline) (27.3±6.9) compared to controls (n=33; 24.6±9.9; p<0.05). Among depressed patients (n=27), those receiving the intervention (n=15) reported significantly lower mean depression scores at four-weeks post-baseline (22.5±12.9) compared to controls (n=12; 27±9.9; p<0.05). The STAART intervention enhanced HIV treatment readiness by better preparing patients prior to initiating HAART. It was also beneficial for reducing depressive symptoms in depressed, HIV-positive patients.

Acknowledgments

This study was partially supported by a grant from the AIDS Bureau, Ontario Ministry of Health and Long-Term Care, CIHR, and OHTN. Jonathan B. Angel and D. William Cameron are Ontario HIV Treatment Network Career Scientists. Curtis L. Cooper is an Ontario HIV Treatment Network Scholar. For a copy of the STAART manual, please contact Dr. Louise Balfour.