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Research on Adherence Patients with HIV infection must take 95% of their pills to achieve an 80% probability that plasma HIV-RNA will be maintained at less than 50 copies/ mL. Adherence below 95% decreases the probability of sustained viral suppression to 50%.
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Research on Adherence • Patients with HIV infection must take 95% of their pills to achieve an 80% probability that plasma HIV-RNA will be maintained at less than 50 copies/mL. • Adherence below 95% decreases the probability of sustained viral suppression to 50%. • Every 10% decrease in antiretroviral adherence has been associated with a 16% increase in mortality. Paterson DL. Ann Intern Med. 2000;133:21-30 Lesho EP. AmerFam Physician. 2003; 68:675-686 Simoni JM. Top HIV Med: International AIDS Society, USA. 2003; 11:185-198 Olson N. JPSW. 2008. July/Aug:11-22 Bartlett, JA. JAIDS, 2002; 29(1):S2-S10
Health Behavior Change • Managing an illness requires behavior modification • To effectively change behavior, a patient must be ready to make the necessary changes • Ambivalence or doubt can be turned into motivation • Helps build the patient’s confidence for success • Improves patient-provider relationships, which leads to better adherence Miller WR, et al. Motivational Interviewing. 2002:217-250.
General Principles of Motivational Interviewing There are four general principles in motivational interviewing: • Roll with Resistance • Express Empathy • Develop Discrepancy • Support Self-Efficacy
GROUP DISCUSSION HIV TREATMENT ADHERENCE