Effects of a brief video intervention on treatment initiation and adherence among patients attending human immunodeficiency virus treatment clinics

PLoS One. 2018 Oct 5;13(10):e0204599. doi: 10.1371/journal.pone.0204599. eCollection 2018.

Abstract

Background: Persons with human immunodeficiency virus (HIV) who get and keep a suppressed viral load are unlikely to transmit HIV. Simple, practical interventions to help achieve HIV viral suppression that are easy and inexpensive to administer in clinical settings are needed. We evaluated whether a brief video containing HIV-related health messages targeted to all patients in the waiting room improved treatment initiation, medication adherence, and retention in care.

Methods and findings: In a quasi-experimental trial all patients (N = 2,023) attending two HIV clinics from June 2016 to March 2017 were exposed to a theory-based, 29-minute video depicting persons overcoming barriers to starting treatment, taking medication as prescribed, and keeping medical appointments. New prescriptions at index visit, HIV viral load test results, and dates of return visits were collected through review of medical records for all patients during the 10 months that the video was shown. Those data were compared with the same variables collected for all patients (N = 1,979) visiting the clinics during the prior 10 months (August 2015 to May 2016). Among patients exposed to the video, there was an overall 10.4 percentage point increase in patients prescribed treatment (60.3% to 70.7%, p< 0.01). Additionally, there was an overall 6.0 percentage point improvement in viral suppression (56.7% to 62.7%, p< 0.01), however mixed results between sites was observed. There was not a significant change in rates of return visits (77.5% to 78.8%). A study limitation is that, due to the lack of randomization, the findings may be subject to bias and secular trends.

Conclusions: Showing a brief treatment-focused video in HIV clinic waiting rooms can be effective at improving treatment initiation and may help patients achieve viral suppression. This feasible, low resource-reliant video intervention may be appropriate for adoption by other clinics treating persons with HIV.

Trial registration: http://www.ClinicalTrials.gov (NCT03508310).

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care Facilities
  • Ambulatory Care* / methods
  • Anti-HIV Agents / therapeutic use*
  • Female
  • HIV Infections / therapy*
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance*
  • Patient Education as Topic* / methods
  • Treatment Outcome
  • Video Recording
  • Viral Load
  • Young Adult

Substances

  • Anti-HIV Agents

Associated data

  • ClinicalTrials.gov/NCT03508310

Grant support

The data collected and used for this study were funded by the Health and Human Services Secretary’s Minority AIDS Initiative and by the Centers for Disease Control and Prevention through contract number 200-2013-57577 awarded to Sentient Research. The Secretary’s Minority AIDS Initiative provided direct funding. The Centers for Disease Control and Prevention provided direct funding and support in the form of salaries for authors MSN, ADM, CBB and SAF, but did not have any additional role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contribution’ section. The four authors who are employees of the Centers for Disease Control and Prevention had roles in study design, data collection and analyses, decision to publish, and preparation of the manuscript. Two authors are employees of the commercial company, Sentient Research (AP and JAM), and had roles in study design, data collection, and preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contribution’ section.