Adherence, HIV Infection
Conditions
Brief summary
Interventions incorporating constructs from behavioral economics and psychology have the potential to enhance HIV 'treatment as prevention' (TasP) strategies. To test this hypothesis, the investigators evaluated a combination intervention to improve antiretroviral therapy (ART) adherence based on the concepts of social norms and priming.
Detailed description
The investigators conducted a quasi-experimental pilot study of a combination behavioral intervention based on the concepts of social norms and priming. The intervention included visual feedback about clinic-level retention in care, a self-relevant prime, and useful take-home items with the priming image. The intervention was developed using tools from marketing research and patient-centered design. The hypothesis was that the intervention would improve retention in care and adherence to ART among patients living with HIV infection (PLHIV). The intervention was implemented at two HIV primary clinics in Shinyanga, Tanzania in 2-week intervals for six months. The investigators reviewed medical records of a random sample of exposed and unexposed adult PLHIV to compare retention and the proportion of patients with medication possession ratio (MPR) ≥95% after six months.
Interventions
BEHAVIORALIntervention
The intervention includes a clinic-based component and a take-home component. All components include the priming image of a Baobab tree. The clinic-based component is an interactive poster that rewarded appointment attendance. Patients who attend three consecutive on-time visits are congratulated and given a colored sticker to place on a poster that is publicly displayed at the clinic. In one clinic, the take-home component is a 2015 calendar in Kiswahili that contained the priming Baobab image. In the other clinic, the take-home component is a small plastic pillbox featuring the Baobab logo.
Sponsors
Ministry of Health, Tanzania
Mexican National Institute of Public Health
University of California, Berkeley
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. At least 18 years of age 2. Living with HIV infection 3. Receiving HIV primary care at one of the two study clinics
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Retention in care, defined as an attended visit between 150-210 days after the baseline visit | 6 months | This measure of retention in care accounts for variability in visit scheduling by individual providers and therefore uses a window period of 150-210 days to determine whether the patient was in care at 6 months |
| >=95% medication possession ratio (MPR) | 6 months | MPR is a measure of ART adherence that is correlated with viral suppression |
Secondary
| Measure | Time frame |
|---|---|
| The proportion of scheduled visits that were completed during the 6-month observation period | 6 months |
| Medication possession ratio (MPR), continuous scale | 6 months |
Countries
Tanzania
Outcome results
None listed