Feasibility of Four Interventions to Improve Treatment Adherence in Migrants Living with HIV in The Netherlands
Sabrina K. Been,
David A.M.C. van de Vijver,
Jannigje Smit,
Nadine Bassant,
Katalin Pogány,
Sarah E. Stutterheim,
Annelies Verbon
Affiliations
Sabrina K. Been
Division of Infectious Diseases, Department of Internal Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
David A.M.C. van de Vijver
Viroscience Department, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
Jannigje Smit
Department of Internal Medicine, Maasstad Hospital, P.O. Box 9100, 3007 AC Rotterdam, The Netherlands
Nadine Bassant
Division of Infectious Diseases, Department of Internal Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
Katalin Pogány
Department of Internal Medicine, Maasstad Hospital, P.O. Box 9100, 3007 AC Rotterdam, The Netherlands
Sarah E. Stutterheim
Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
Annelies Verbon
Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
We evaluated the feasibility and efficacy of four existing interventions to improve adherence to them in migrants living with HIV (MLWH): directly administered antiretroviral therapy (DAART), group medical appointments (GMA), early detection and treatment of psychological distress, and peer support by trained MLWH. At baseline and after the interventions, socio-demographic characteristics, psychosocial variables, and data on HIV treatment adherence were collected. The two questionnaires were completed by 234/301 (78%) MLWH included at baseline. Detectable HIV RNA decreased (from 10.3 to 6.8%) as did internalized HIV-related stigma (from 15 to 14 points), and self-reported adherence increased (between 5.5 and 8.3%). DAART and GMA were not feasible interventions. Screening of psychological distress was feasible; however, follow-up diagnostic screening and linkage to psychiatric services were not. Peer support for and by MLWH was feasible. Within this small intervention group, results on HIV RNA < 400 copies/mL (decrease of 23.6%) and outpatient clinic attendance (up to 20.4% kept more appointments) were promising.
