Treatment News : Computerized Counseling Ups Adherence, Lowers Risky Sex

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January 21, 2014

Computerized Counseling Ups Adherence, Lowers Risky Sex

A computerized counseling program for people with HIV improves treatment adherence and reduces viral load and risky sexual behavior, aidsmap reports. Publishing their findings in the Journal of Acquired Immune Deficiency Syndromes, investigators in Seattle randomly assigned 240 adults to either have access to the Computer Assessment and Rx Education for HIV-positive people program (CARE+) over a nine-month period, or to serve in a control group that did not receive the computerized counseling.

The CARE+ program counseled participants about treatment adherence, HIV disclosure, safer sex, condom use, substance abuse and how adherence affects viral load.

The change in viral load between the beginning and end of the study was somewhat statistically significant between the two groups, meaning there is less certainty that the difference did not occur by chance. Those who received the counseling experienced a 0.17 log10 drop in viral load, while those in the control group saw their viral loads increase by 0.13 log10. (A log10 is a power of 10. Viral loads are expressed in logs because they can vary so widely. To see a chart diagramming viral loads in terms of logs, click here. For example, if someone had a viral load of 1,000, which is expressed as 3.0 log10, and saw his viral load drop by 0.13 log10, to 2.77 log10, he would then have a viral load between 632 and 794.) People in the CARE+ program saw a significantly increased likelihood of achieving an undetectable viral load at the end of the study, compared with a non-significant drop for those in the control group.

Looking just at those who started the study with a detectable viral load, those in the intervention group experienced an average significant drop in viral load of 0.60 log10, compared with an average non-significant rise in viral load of 0.15 log10 in the control group. Those who received the counseling had a significantly lower viral load than those who did not by a factor of 0.73 log10.

Those in the intervention group increased their adherence by 5 percent while there was a non-significant 1.3 percent drop in adherence among those who did not receive the counseling.

Among those with a detectable viral load at the outset of the study, those in the intervention group demonstrated an 8 percent rise in adherence, compared with a non-significant drop of 1.5 percent among those in the control arm. At the study’s end, the adherence of those who received the CARE+ program increased by 13 percent compared with those who did not receive any counseling.

To read the aidsmap story, click here.

To read the study abstract, click here.

Search: HIV, computerized counseling, treatment adherence, viral load, risky sex, Journal of Acquired Immune Deficiency Syndromes, Seattle, Computer Assessment and Rx Education for HIV-positive people, CARE+.

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