Culturally-Congruent Counseling Intervention for Supporting Antiretroviral Therapy Adherence

The culturally congruent adherence intervention was associated with a significant increase in adherence, decreased medical mistrust, and reduced HIV-stigmatizing beliefs. The intervention was cost-effective and compatible with the needs of the Black population.  

Black Americans with human immunodeficiency virus (HIV) infection tend to have relatively low rates of viral suppression and adherence to antiretroviral therapy (ART) regimens. Bogart et al. conducted a randomized controlled trial to assess the outcomes of a culturally congruent counseling intervention for improving adherence to ART regimens among Black Americans with HIV, called Rise. The findings of the study are published in the journal AIDS and Behavior.

Study Population

Of the 245 participants, 122 and 123 were randomized to intervention and control groups, respectively. The intention-to-treat analyses included 175 participants at seven-month and 166 at 13-month follow-ups. The average age of the participants was 49.1 ± 12.4 years.

Effect of Rise Intervention on Viral Suppression and Treatment Adherence

The intervention led to improvement in adherence to the ART regimen, as reflected by a relatively greater number of intervention group participants who demonstrated optimal adherence to the treatment. The effects of the Rise intervention on treatment adherence were relatively stronger for younger participants.

Effect of Rise Intervention on Psychosocial Outcomes in HIV Participants

The intervention led to a significant decline in medical mistrust related to HIV. However, the decrease in general medical mistrust was not significant. The intervention also reduced the stigmatization of HIV-related beliefs. Rise was non-significantly related to the disclosure of HIV serostatus and internalized HIV stigma.

Cost-Analysis of Culturally Congruent Adherence Intervention

The intervention cost before the pandemic was $465 for every 10% increase in adherence to the treatment. Before the pandemic, the range of intervention costs was $317–$875. The cost of intervention during the pandemic, conducted via telephone, was $141 for every 10% increase in adherence. The range of the intervention cost was $124–$165.  

Source:

Bogart, L. M., Mutchler, M. G., Goggin, K., Ghosh-Dastidar, M., Klein, D. J., Saya, U., Linnemayr, S., Lawrence, S. J., Tyagi, K., Thomas, D., Gizaw, M., Bailey, J., & Wagner, G. (2022). Randomized Controlled Trial of Rise, A Community-Based Culturally Congruent Counseling Intervention to Support Antiretroviral Therapy Adherence Among Black/African American Adults Living with HIV. Aids and Behavior, 27(5), 1573–1586. https://doi.org/10.1007/s10461-022-03921-0