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Computer interventions effective for improving ART adherence

Tuesday, 11 February, 2014

Computer-based interventions were found to be effective at improving antiretroviral (ART) adherence and reducing onwards transmission of HIV in the United States, according to a study published ahead of print in the Journal of Acquired Immune Deficiency Syndrome. The study found that viral load had improved among the group who followed the computer intervention, called CARE+, and significantly improved among those with a very low viral load at baseline.

Antiretroviral treatment means that people living with HIV can live a long and healthy life, whilst also reducing the chance of transmitting the virus to others. Ensuring that people are on ART and have a suppressed viral load is as much now a personal medical decision, as it is a public health decision. In the US, people living with HIV are now recommended to be on treatment for life – however only 77 percent of people on ART are able to maintain a suppressed viral load.

Interventions to improve adherence are essential for improving the morbidity and mortality of people living with HIV. CARE+ is an interactive software aimed to help improve the health and sexual risk behaviours of people living with HIV, through risk assessment, tailored feedback and referrals, interactive videos and health plans. After nine months of the programme, ART adherence increased by 10 percent – a modest improvement as stated by the authors, however the viral load increase was clinically significant, both for the health of the person, but also for onward transmission.

The authors state: “interventions to support adherence have tended to show relatively small effects, highlighting the need for efficacious interventions that can be implemented without straining the healthcare system resources, as is the promise of computerised counselling tools such as CARE+.”