 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Paul W. Colson, PhD1, Julie Franks, PhD2, Christopher Davis2, Wafaa M. El-Sadr, MD, MPH3, and Sharon B. Mannheimer, MD4. (1) Charles P. Felton Nat. TB Ctr., Harlem Hospital Center, 2238 Fifth Ave., New York, NY 10037, 212-939-8241, pwc2@columbia.edu, (2) Harlem Hospital Center, Columbia University, 506 Lenox Avenue rm 3101-A, New York, NY 10037, (3) Division of Infectious Diseases, Mailman School of Public Health at Columbia Universtiy and Harlem Hospital, Harlem Hospital 506 Lenox Avenue, 506 Lenox Avenue, Room 3101A, New York, NY 10037, (4) Harlem Hospital Center, Columbia University College of Physicians and Surgeons, 506 Lenox Avenue rm 3101-A, New York, NY 10037
Background: HIV-infected persons with severe mental disorders (PSMD) face specific risk factors for non-adherence to antiretroviral therapy (ART). Methods: HIV-infected individuals were enrolled into a one-year, peer worker-based intervention to promote ART adh. Peers were HIV-infected, adh to ART, from the same communities as participants, and trained to provide adh support. Support was provided through one-on-one encounters, each documented in contact forms. Structured baseline interviews were conducted to collect socio-demographic and health characteristics and self-reported ART adh over the previous three days. Pts with a previous psychiatric hospitalization and/or were taking psychiatric medications at baseline were defined as PSMD. Results: 37 of 139 clients (27%) classified as PSMD, including 65% women; 76% African-Americans; 24% Latinos; with a mean age of 41 (range 22 -65). Active substance use was reported by 46% and homelessness by 22%. Mean adh was 69% of prescribed doses. Peers made 608 contacts, with a mean of 16 (range 0 - 82) contacts per PSMD pt over the year; 43% face-to-face. Peers initiated 71% of contacts; pts, 28%. Peers discussed ART adh in 67% of contacts. They addressed significant life stressors (e.g. housing) in 44% of contacts, provided counseling in 26%, health education in 16%, and referrals for additional services in 27%. Conclusions: A high prevalence of HIV-infected PSMD with multiple potential barriers to adherence was found. Peers successfully reached the PSMD, providing frequent contact and both adh-specific and more general social support. Future analysis will determine the effect of peer support on adh among PSMD.
Learning Objectives:
Keywords: HIV Interventions, Peer Counselors
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.