January 13, 2014
This article was reported by NAM aidsmap.
NAM aidsmap reported on a study that evaluated a computer-delivered intervention called Computer Assessment and Rx Education for HIV-positive people (CARE+). The researchers used a nine-month randomized controlled trial with 240 adult patients on antiretroviral therapy (ART) to determine whether CARE+ improved treatment adherence and decreased transmission risk behaviors among HIV-positive individuals. Participants had a mean age of 45 years and 90 percent were male.
Participants in the intervention arm were free to use the CARE+ program, which provided counseling on treatment adherence, HIV disclosure, safer sex, condom use, substance abuse, and the impact of adherence on viral load. Those in the control arm completed computerized questionnaires on treatment adherence, substance use, and sexual risk behavior. Primary outcomes were changes from baseline in viral load, 30-day adherence to ART, and likelihood of reporting unprotected sex or problems with condom use. At baseline, participants reported taking a median of 76 percent of their ART doses; 30 percent reported unprotected sex or condom problems, and viral load was detectable in 30 percent.
Researchers associated CARE+ with significant decreases in viral load, increases in ART adherence, and improvements in HIV transmission risk behavior. Participants found the program acceptable: 97 percent found it easy to use and 93 percent felt the session helped them as much as, if not more, than in-person counseling. The researchers concluded that CARE+ was highly acceptable and facilitated delivery in busy settings. They suggested additional evaluation of this type of programming to determine its usefulness in improving HIV treatment outcomes and reducing secondary transmission among HIV-positive individuals.