The initial feasibility of a computer-based motivational intervention for adherence for youth newly recommended to start antiretroviral treatment

Abstract

Young people represent the largest number of new HIV infections, thus youth living with HIV (YLH) are likely to be the largest group to initiate antiretroviral treatment (ART). Adherence patterns for behaviorally infected YLH are not adequate to effectively manage the disease; therefore, novel interventions are needed to improve medication adherence. The purpose of the current study, which will precede a randomized controlled trial, was to assess the initial feasibility of an individually tailored computer-based two-session interactive motivational interviewing (MI) intervention for YLH newly recommended to start ART. Intervention development occurred in collaboration with three youth advisory groups. Ten youth (ages 18–24) were recruited to participate in this study. Participants completed the intervention online. Intervention components focused on medication adherence (rating perceived importance and confidence, and goal setting). Retention was 100% for both intervention sessions. All participants (n=10) felt medication adherence was important, but 80% felt confident they could manage their adherence to HIV medications. Ninety percent of participants set the goal of taking their HIV medications exactly as prescribed and reported success achieving this goal at follow-up. Additionally, participants were satisfied with the quality of the sessions and the amount of assistance they received for managing their adherence to HIV medications (90% participants for Session 1; 89% for Session 2). Per exit interview responses, participants felt that the intervention made them think more about their health and was a motivator for them to take better care of their health. In conclusion, the intervention was feasible for YLH enrolled in the study.

Keywords:

• HIV
• youth
• motivational interviewing
• medication adherence
• computer intervention

Acknowledgments

This work was supported by The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) from the National Institutes of Health [U01 HD 040533 and U01 HD 040474] through the National Institute of Child Health and Human Development (B. Kapogiannis, R. Hazra, C. Worrell), with supplemental funding from the National Institutes on Drug Abuse (N. Borek) and Mental Health (S. Allison). The ATN's Behavioral Leadership Group scientifically reviewed the study. Network, scientific, and logistical support was provided by the ATN Coordinating Center (C. Wilson, C. Partlow) at the University of Alabama at Birmingham. The ATN Data and Operations Center at Westat, Inc. (K. Vellala, M. Saar) provided network operations and data management support. We acknowledge the contribution of the investigators and staff at the following ATN 072 sites that participated in this study: St. Jude Children's Research Hospital, Memphis, TN (Flynn, Stender, Dillard, McKinley) and University of Miami School of Medicine (Friedman, Maturo, Major-Wilson). We sincerely thank the members of the local youth Community Advisory Boards for their insight and counsel and are particularly indebted to the youth who participated in this study.