AEGiS-15IAC: The trials and tribulations of "clinical success" in HIV: exploring new issues and challenges.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

The trials and tribulations of "clinical success" in HIV: exploring new issues and challenges.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10168)

Alfonso V, Geller J, Montaner JS
Canadian HIV Trials Network/University of British Columbia, Vancouver, Canada

BACKGROUND: Accomplishing the goal of antiretroviral therapy, to achieve and maintain an undetectable viral load in plasma, is challenging given that drug regimens require near perfect adherence in order to be effective. To date, most research efforts in the area of adherence have examined adherence problems, and attention has focused on supporting individuals who are failing, or who are at high risk of failing therapy. Little is known about the experiences of individuals who are successful on therapy. The purpose of this research is to increase understanding of how individuals who have maintained undetectable viral loads account for their clinical success, and to identify challenges, as well as possible needs, for continued success.

METHODS: A qualitative interview methodology was used. Study participants completed two 60-minute interviews within a two-month period, and a critical incident methodology was used to identify critical incidents, categories, and sub-categories. Twenty volunteer subjects receiving outpatient treatment participated in this study.

RESULTS: Of the 438 critical incidents collected, 316 were identified as helpful, and 122 were identified as unhelpful. Helpful categories included resolving ambivalence about living with HIV, fostering helpful relationships, and using personal strengths. Unhelpful categories were depressed mood, financial difficulties, medication factors, and lack of social support. Overarching themes underlying the categories were adjusting to loss, maintaining a balance between hope and uncertainty, and achieving a sense of control.

CONCLUSIONS: This study provides a detailed description of the experiences of individuals who are successfully taking antoretoviral therapy. The extrapolated themes can be used by health practitioners in preparing individuals for antiretroviral therapy and in discussing ways to maintain or increase adherence.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV, HIV Seropositivity, Viral Load, HIV Infections, Anti-HIV Agents, HIV-1, Antiretroviral Therapy, Highly Active, HIV Protease Inhibitors, Drug Therapy, Combination, Disease Progression, HIV Integrase, therapy, drug therapy

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B10168