An examination of the Index of Readiness as a predictor of adherence and an adherence intervention in HIV+ males who repeatedly failed anti-HIV treatment regimens (Immune deficiency)

Successful treatment of HIV infection requires the ability to sustain nearly perfect adherence to anti-HIV medications. Non-adherence to anti-HIV medications often results in drug resistance and treatment failure. In an effort to avoid drug resistance due to non-adherence, health care providers think that HIV+ individuals must be ready prior to initiating anti-HIV medications. Little research has been devoted to examining the relationship between readiness and HIV treatment adherence. In addition, HIV+ individuals who have repeatedly failed treatment have typically been omitted from adherence studies. The purposes of this quasi-experimental study were to examine the relationship between readiness and adherence to anti-HIV medications and to study the feasibility and effects of a multi-disciplinary adherence intervention entitled "STAR". Subjects were 19 previously medication-experienced HIV+ males beginning a new regimen of anti-HIV medications. The control group (n = 7) received the routine standard of care, while the intervention group (n = 12) received the STAR intervention. All subjects (n = 19) completed the Index of Readiness, an instrument measuring readiness, at the onset of the study. There was a statistically significant difference between those subjects reaching viral suppression (PCR < 400) in the experimental group and those not reaching viral suppression in the control group at the end of the six-month study period. Subjects who experienced viral suppression had higher readiness scores with statistically significant higher scores on subscale 2 of the Index of Readiness, The effect sizes for all subscales and the total Index of Readiness scale scores were very sizable. Results from this study suggest that readiness may be a key component in successful adherence to anti-HIV treatment and that the Index of Readiness may predict the ability to adhere to anti-HIV medications. This study may also suggest that the STAR intervention is effective in enhancing adherence in HIV+ persons who have repeatedly failed previous anti-HIV treatment. Implications for future research include additional studies with larger samples to further examine the STAR intervention, to further explore the relationship between readiness and adherence, and to determine if the Index of Readiness predicts adherence to anti-HIV treatment.