Enhancing Adherence to HIV Therapies: A Multidisciplinary Approach
A Conference Introduction by Marcelo Marer
On May 15, 1998, Body Positive and the Clinical Education Initiative at Mount Sinai Medical Center will present a one-day conference titled "Enhancing Adherence to HIV Therapies: A Multidisciplinary Approach." Speakers will discuss current research findings, and people living with HIV will present actual case studies.
The conference will start with an overview of research on adherence from both the basic science/clinical and behavioral science perspectives, followed by a historical overview. Calvin Cohen, M.D., Research Director at Community Research Initiative of New England, will present a clinical overview of the most recent research on adherence to HIV therapies, providing a bridge between basic science and clinical research. Dr. Cohen will address the development of HIV resistance or cross-resistance to current available therapies, and how this phenomenon affects one's future treatment choices. This is a particularly urgent issue, especially considering recent data suggesting that if the first protease regimen fails, the second one will not be as potent. The question remains: Do we have realistic HIV therapy regimens to which people will be able to adhere for the long haul?
After Dr. Cohen speaks, Jeannette Ickovics, Ph.D., Assistant Professor of Epidemiology and Public Health at Yale University, will present an overview of ongoing research on adherence from a behavioral standpoint, with particular emphasis on how to best measure binomial adherence/non-adherence (e.g., patient self-reporting in adherence interventions).
Finally, Barron Lerner, M.D., Ph.D., Arnold P.Gold Foundation, Assistant Professor of Medicine at Columbia University, will outline the historical context underlying the current discussion on adherence to HIV therapies, showing that concerns with patient's adherence are not new, and have often informed public health policies.
The second part of the conference will feature three multidisciplinary and multilevel panels, composed by basic scientists, behavioral scientists, clinical practitioners (nurses and physicians) and people living with HIV. They will address adherence to HIV therapies by focusing on three pivotal stages: 1. Starting HIV Therapies; 2. Maintaining HIV Therapies; and 3. Adherence and Double Therapies. The first panel will address issues that include the consumer's readiness, the role providers should play along the continuum of care to maximize readiness, the doctor-patient relationship, and biological markers. The second panel will explore consumer self-reporting, the development of trust in the doctor-patient relationship and with other providers, and how biological markers can be used to monitor and maximize adherence. The third panel will analyze the consumer's readiness to start a new regimen, complicated clinical and behavioral factors, and the idea of switching HIV therapies in the context of recent scientific findings.
Finally, in the summary panel "Where Do We Go from Here?" we will review the most important issues addressed at the conference, with special attention given to promising strategies for enhancing adherence. Among the speakers already confirmed are: Daniel Baxter, M.D. (Ryan Center); Calvin Cohen, M.D. (C.R.I. of New England/Harvard University); N. Patrick Hennessey, M.D. (NYU); Gary Kalkut, M.D. (Montefiore Medical Center); Jeannette Ickovics, Ph.D. (Yale University); Debbie Indyk, Ph.D. (Mount Sinai Medical Center); Jeffrey Jacobson, M.D. (Mount Sinai Medical Center); Israel Lowy, M.D. (Mount Sinai Medical Center); Susana Morales, M.D. (Columbia University); Michael Mullen, M.D. (Cabrini Medical Center); Kathleen Nokes, Ph.D. (CUNY); Robert Remien, Ph.D. (Columbia University); David Rubin, M.D. (New York Hospital of Queens); Jane Simoni, Ph.D. (Yeshiva University), and Diana Williamsom, M.D. (Harlem United/ Mount Sinai Medical Center).
For further information and registration material, please contact Elizabeth Levine or Marcelo Marer, located at Body Positive's Education Department, at (212)566-7333 or e-mail Bodyposedu@aol.com.
The article "HIV Treatment: The Importance of Adherence" was written in July 1997 and published in the October issue of Body Positive. It has been reprinted in this special issue, because it offers an abbreviated version of the issues and philosophy underlying the design of the upcoming conference.
This article was provided by Body Positive. It is a part of the publication Body Positive.