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Acceptance-based intervention to promote HIV medication adherence
Dissertation   Open access

Acceptance-based intervention to promote HIV medication adherence

Ethan Moitra
Doctor of Philosophy (Ph.D.), Drexel University
May 2009
DOI:
https://doi.org/10.17918/etd-3035
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Abstract

HIV infections--Treatment Antiretroviral agents Clinical Psychology
Human immunodeficiency virus (HIV) is a global health concern. Although effective pharmacological treatments, such as highly active antiretroviral therapy (HAART) have been developed and implemented, a significant number of adults with HIV in the U.S. do not maintain adherence at adequate levels for treatment to work. The data suggest HIV medications should be taken 90% of the time or more, though typically Americans with HIV take their medications 60% to 70% of the time. Although some promising results have been shown using traditional cognitive-behavior therapies, an acceptance-based approach to HAART adherence may be preferable in this population because of the significant role played by denial. We compared treatment-as-usual to treatment-as-usual plus an acceptance-based intervention for increasing HAART adherence in a predominantly minority, low socio-economic status sample of 31 uninsured adults in a large metropolitan community primary care clinic. Results revealed no differences in the interventions on self-rated measures of adherence. However, patients in the acceptance-based group showed greater improvements in CD4 level gains over time relative to those who received treatment-as-usual. Secondary analyses revealed that baseline anxiety and baseline mindful acceptance predicted adherence at follow-up. These data suggest that acceptance-based strategies are promising tools for increasing adherence to HAART among HIV-positive persons. Future studies with larger samples are needed to expand upon these results, including adapting the intervention to an individual treatment format.

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