This time the setting was a discussion of study results that had led to dolutegravir , an antiretroviral medicine strongly preferred for its effectiveness and lack of side effects, being withheld from women of child-bearing potential for the preceding 15 months until newer study results clearing the drug from linkage to birth defects showed that the medicine need not have been withheld. Informing women of the potential risks of the medicine and providing them the opportunity to make informed choices would have made all the difference in averting those impacts, Amb.
Birx and other speakers discussing the re-opened access to the drug said. On Tuesday here, presenters in a session on Community Engagement in Research discussed the efforts they had made to elicit input from participants in cure, vaccine, and long-acting HIV prevention trials.
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What they meant by that remained unclear. Another presenter shared a chart showing high educational attainments among participants in a survey — more than a few with postgraduate degrees. It was an unusual group she allowed; funding constraints had prevented translating the survey, limiting potential participants to ones who could speak English.
Another told of the studies in which she was involved that required monthly infusions of the preventive measure being tested, making strong community buy-in paramount to trial retention. Journal of Acquired Immune Deficiency Syndromes 44 2 Charlebois, S. Morin, R. Remien, M. Effects of a behavioral intervention on antiretroviral medication adherence among people living with HIV: The Healthy Living Project randomized controlled study.
Journal of Acquired Immune Deficiency Syndromes 46 5 Pals, T. Bush, M. Pratt Palmore, D. Stratford, and T.
Randomized controlled trial of an intervention to prevent adherence failure among HIV-infected patients initiating antiretroviral therapy. Health Psychology 27 2 Cherry, M. Kalichman, C.
Amaral, D. White, H. Pope, C.
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Swetzes, L. Eaton, R. Macy, and D. American Journal of Public Health 3 Bellamy, J. Chapman, X. Han, J. Palmer, P. Houts, J. Coyne, and B. Managed problem solving for antiretroviral therapy adherence: A randomized trial. Huh, P.
Frick, C. Pearson, M. Andrasik, P. Dunbar, and T. Peer support and pager messaging to promote antiretroviral modifying therapy in Seattle: A randomized controlled trial.
Journal of Acquired Immune Deficiency Syndromes 52 4 Richardson, A. McCutchan, S.
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AIDS and Behavior 20 5 The EBIs included in the compendium overwhelmingly focus on adult populations and seldom address the unique developmental and contextual factors shaping AYA engagement, adherence, and retention in HIV services.
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Interestingly, the type of service, frequency of patient contact, HIV service provider, and means and setting of service delivery used by the only AYA-centered EBI differ markedly from those used by the majority of the adult-focused EBIs. TXTXT relies on adherence reminders, daily patient contact, and automated service delivery via text message.
However, the majority of EBIs in the compendium 13 out of 19 , including the only AYA-specific intervention, focus on supporting medication adherence, rather than linkage and retention in care see Figure 3 [10,27]. The guidelines highlight AYA-specific factors contributing to difficulties with medication adherence that warrant individualized clinical responses.
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Recommendations include implementing adherence support systems, such as reminder systems; avoiding complex medication regimens, and directly observing therapy. For severe or recurring adherence problems, regimens involving high resistance barriers and delay or suspension of antiretroviral therapy may be considered. Furthermore, the guidelines emphasize the importance of facilitating the transition into adult care for AYA living with HIV.
The HHS recommendations for transition care include pre-transition interventions, such as individualized transition plans, as well as post-transition interventions, such as support groups. Since , the ATN has initiated roughly a hundred scientific studies, significantly advancing the understanding of the underlying factors driving HIV disparities among AYA. The toolkit serves as a resource to support AYA-friendly clinic infrastructure, staffing, and services for HIV prevention and treatment. Important best practices that emerge from the toolkit include frequent and informal communication with AYA, such as text and social media; provision of support services beyond medical care by interdisciplinary staff e.