Content and effectiveness of the Adherence Improving self-Management Strategy (AIMS) in HIV-care

Abstract

Background: Few – if any – scalable interventions to promote adherence to Antiretroviral Therapy for HIV have demonstrated a meaningful impact on viral suppression. This presentation describes the development and early testing of the Adherence Improving self-Management Strategy (AIMS), and the results of a multi-centre trial examining its effectiveness, compared to treatment-as-usual. Methods: AIMS is a theory-based intervention developed collaboratively with HIV-nurses and patients. A previous single-site RCT established that AIMS impacts on medication adherence. The current multi-centre RCT trial was powered to detect an effect of AIMS on clinical outcomes. Findings: 223 patients were randomized and 213 patients completed the trial, with a mean follow-up of 14.5 months. The primary intent-to-treat analyses using log-transformed viral loads showed that AIMS was effective (F(1,199)=7.23, p=.008). Secondary detectable-undetectable (OR:2.03, 95%CI 1.06-3.89) and treatment-failure analyses (OR:3.09, 95%CI 1.18-7.94) corroborated this finding. Discussion: This trial demonstrated that the AIMS-intervention is effective and has a relevant impact on viral load. Its cost-effectiveness and impact in other conditions remains to be explored.