Abstract

Session presented on: Thursday, July 25, 2013:

Purpose: To test the effectiveness of a culturally adapted evidence-based home nursing intervention to improve adherence to antiretroviral medications among people living with HIV/AIDS (PLWH/A) in Hunan, China.

Methods: In a randomized, controlled trial, 114 subjects were assigned to receive a culturally adapted intervention consisting of monthly visits and interim phone calls plus standard care or standard care alone. The intervention previously demonstrated efficacy in a randomized clinical trial conducted in the United States. All subjects were residents of Hunan, China, living with HIV/AIDS and self-reporting less than 90% adherence to prescribed medications. Measures included a 7-day visual analogue medication adherence scale, a social support rating scale, the Chinese version of the Center for Epidemiological Studies Depression scale Chinese, and an HIV/AIDS stigma scale. Data were collected in structured face-to-face interviews at baseline, 6 months, and 12 months at the time of a regularly scheduled clinical visit. Information regarding ARV regimen, treatment duration, time of diagnosis, CD4 count and HIV-RNA was extracted from the medical record.

Results: Subjects were 72% male (N=82); 52% (N=59) married; and only 28% (N=32) stably employed. Thirty-one percent (N=35) reported past or current drug abuse. The great majority (98%) had a CD4 count at baseline that was less than 350 cells/mm3. At 6 months and 12 months, a greater proportion of subjects in the intervention group self-reported adherence greater than 90% compared to the control group. The difference over time is significant (Extended Mantel-Haenszel Test: 8.8, p=.003).

Conclusions: In spite of significant cultural differences, evidence-based interventions can be implemented effectively in new settings and with new populations.

Author Details

Ann Bartley Williams, EdD, RN; Kristopher P. Fennie, MPH, PhD; Xian Hong Li, PhD, RN; Jane Burgess, MS, RN, ACRN; Hong Hong Wang, PhD, RN

Sigma Membership

Unknown

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Home Nursing Intervention, HIV/AIDS, Medication Adherence

Conference Name

24th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Prague, Czech Republic

Conference Year

2013

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All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Adapting and testing an evidence-based antiretroviral medication adherence intervention in China

Prague, Czech Republic

Session presented on: Thursday, July 25, 2013:

Purpose: To test the effectiveness of a culturally adapted evidence-based home nursing intervention to improve adherence to antiretroviral medications among people living with HIV/AIDS (PLWH/A) in Hunan, China.

Methods: In a randomized, controlled trial, 114 subjects were assigned to receive a culturally adapted intervention consisting of monthly visits and interim phone calls plus standard care or standard care alone. The intervention previously demonstrated efficacy in a randomized clinical trial conducted in the United States. All subjects were residents of Hunan, China, living with HIV/AIDS and self-reporting less than 90% adherence to prescribed medications. Measures included a 7-day visual analogue medication adherence scale, a social support rating scale, the Chinese version of the Center for Epidemiological Studies Depression scale Chinese, and an HIV/AIDS stigma scale. Data were collected in structured face-to-face interviews at baseline, 6 months, and 12 months at the time of a regularly scheduled clinical visit. Information regarding ARV regimen, treatment duration, time of diagnosis, CD4 count and HIV-RNA was extracted from the medical record.

Results: Subjects were 72% male (N=82); 52% (N=59) married; and only 28% (N=32) stably employed. Thirty-one percent (N=35) reported past or current drug abuse. The great majority (98%) had a CD4 count at baseline that was less than 350 cells/mm3. At 6 months and 12 months, a greater proportion of subjects in the intervention group self-reported adherence greater than 90% compared to the control group. The difference over time is significant (Extended Mantel-Haenszel Test: 8.8, p=.003).

Conclusions: In spite of significant cultural differences, evidence-based interventions can be implemented effectively in new settings and with new populations.