ARV Adherence Counseling Skill Building Workshop

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ARV Adherence CounselingSkill Building Workshop

• Sangworn Sombatmai
• Sombat Tapanya
• Chiang Mai University, Thailand

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Reducing Dropout and Increasing Adherence to
HAART in District Hospitals in Northern Thailand

• Introduction to the project

3
Partners

• RIHES, Chiang Mai University
• Faculty of Medicine, Chiang Mai University
• CDC10 AIDS, TB and STD Bureau, MOPH
• Horizons, Population Council
• Sites
• 4 Northern Provinces Chiang Mai, Chiang Rai,
  Lampang, Lamphun
• 1 Provincial hospitals (PH)
• 44 district hospitals (DH)

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Study design

• Randomized controlled 3 arm study randomization
  at facility level
• Arm 1 Enhanced medical care
• adherence Counseling
• Arm 2 Enhanced medical care adherence
• counseling Peer intervention
• Arm 3 No intervention by project at the
• beginning but be trained on
  medical
• care adherence counseling 6
  months later
• There are 15 hospitals in each arm

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Interventions

• Adherence Counseling arm 1 2
• Motivational adherence counseling
• Preparatory, action and maintenance stages.
• Peer based intervention arm 2
• Provide knowledge on HIV/AIDS care group
  support
• At clinic and home visits (once a month) HIV
  disease, treatment advice, counselling and pill
  counts etc
• Case Conferences arm 1 2
• Physicians, counselors, peer educators,
  occasional PLHA
• Topics disclosure, adherence challenges, drug
  resistance, treatment failure, lactic acidosis,
  ADRs, specific OI s, suicide etc.
• Manual/Guideline for medical care counseling

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Study Design contd.

• ART naïve adult patients be enrolled
• Recruitment undertaken from Mid April October
  2004 ( 6 months)
• Period of rapid expansion of Thai ART program
  (NAPHA)
• Patients followed for 12 months
• Data collection at 0, 4, (8), 12 months
• Data collected by trained nurses working at
  facility but not providing ARV services