Adherence to anti-retroviral therapy (ART) is critical to the success of HIV treatment and treatment as prevention. However, the benefits of ART can be realized only by those individuals who are tested, diagnosed, timely linked to medical care, and start and adhere to ART to achieve viral suppression.
In April 2011, eight individual and group-level evidence-based strategies to support HIV medication adherence were reviewed and identified as “good-evidence” by the Centers for Disease Control & Prevention (CDC) Prevention Research Synthesis Project's Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. The Capacity Building Branch selected four of the eight medication adherence strategies to be translated into an
e-learning training toolkit for clinical and non-clinical HIV providers who serve persons living with HIV (PLWH). The 4 adherence strategies can be delivered by a variety of HIV providers, including medical providers, licensed social workers, HIV case managers, health educators and/or peers.
The Every Dose Every Day e-Learning Training Toolkit features four evidence-based strategies:
- HEART - Individual/dyadic, social support and problem-solving intervention delivered before and in the first two months after initiating ART, includes a patient-identified support partner
- Peer Support - Individual-and group-level intervention, where HIV-positive people, currently adherent to ART, serve as peers and provide medication-related social support
- Partnership for Health for Medication Adherence - Individual-level, clinic-based, brief provider-administered intervention emphasizes the importance of the patient-provider relationship to promote adherence
- SMART Couples - Discordant couple-level intervention, addresses ART adherence and safer sex practices within the dyad, by fostering active support between partners
The toolkit also includes:
- Mobile Application for iOS and Android smartphones featuring dose reminders and pharmacy refills - COMING SOON...
- Consumer handouts about the importance of staying adherent and understanding viral load and CD4 count
- Posters featuring real persons living with HIV and their reason for staying adherent
- Program Monitoring Companion in this document you can find the general information on program monitoring: what it is, how to do it and program monitoring questions that the CDC considers high priority. These questions will be used as examples throughout this document to illustrate how HIV care providers can collect and use data to monitor your program, improve delivery of ART adherence interventions, and ultimately reduce the impact of HIV on individuals and society. The tools for monitoring your program and interpreting your data includes information on outcomes, individual-level and program-level data collection templates, and case studies demonstrating use of program monitoring questions.
To register for the four Medication Adherence e-Learning trainings, visit the HIP e-Learning Center.
Every Dose Every Day Mobile Application
The EVERY DOSE EVERY DAY (E2D2)
mobile application (app) builds on the Pager Messaging intervention by assisting people living with HIV with dose, refill, and medical appointment reminders. Additionally, the app features lab tracking (e.g., viral load and CD4 count) to help the user understand how their HIV treatment regimen supports better health. The user may input important contact information of their health care team. There is also a feature that allows the user to upload a “Reason Photo”, which can serve as an inspirational reminder of why taking your HIV medication every day is important. The user may log reasons for missing a dose and information about a particular dose in the “dose notes” feature for their medications. Dose notes may include information about side effects or whether a medication needs to be taken with or without food. This information may be useful in discussing adherence challenges with their medical provider. The mobile app can be used alone or in combination with any of the 4 medication adherence strategies.