Improving health outcomes for youth living with the human immunodeficiency virus: a multisite randomized trial of a motivational intervention targeting multiple risk behaviors.

TitleImproving health outcomes for youth living with the human immunodeficiency virus: a multisite randomized trial of a motivational intervention targeting multiple risk behaviors.
Publication TypePublication
Year of Publication2009
AuthorsNaar-King S, Parsons JT, Murphy DA, Chen X, D Harris R, Belzer ME
JournalArch Pediatr Adolesc Med
Volume163
Issue12
Pagination1092-8
Date Published2009 Dec
ISSN1538-3628
KeywordsAdolescent, Adolescent Behavior, Anti-HIV Agents, Female, Health Behavior, Health Education, HIV Seropositivity, Humans, Interviews as Topic, Male, Motivation, Patient Compliance, Regression Analysis, Risk-Taking, Sexual Behavior, Substance-Related Disorders, United States, Viral Load, Young Adult
Abstract

<p><b>OBJECTIVE: </b>To determine if Healthy Choices, a motivational interviewing intervention targeting multiple risk behaviors, improved human immunodeficiency virus (HIV) viral load.</p><p><b>DESIGN: </b>A randomized, 2-group repeated measures design with analysis of data from baseline and 6- and 9-month follow-up collected from 2005 to 2007.</p><p><b>SETTING: </b>Five US adolescent medicine HIV clinics.</p><p><b>PARTICIPANTS: </b>A convenience sample with at least 1 of 3 risk behaviors (nonadherence to HIV medications, substance abuse, and unprotected sex) was enrolled. The sample was aged 16 to 24 years and primarily African American. Of the 205 enrolled, 19 did not complete baseline data collections, for a final sample size of 186. Young people living with HIV were randomized to the intervention plus specialty care (n = 94) or specialty care alone (n = 92). The 3- and 6-month follow-up rates, respectively, were 86% and 82% for the intervention group and 81% and 73% for controls. Intervention Healthy Choices was a 4-session individual clinic-based motivational interviewing intervention delivered during a 10-week period. Motivational interviewing is a method of communication designed to elicit and reinforce intrinsic motivation for change. Outcome Measure Plasma viral load.</p><p><b>RESULTS: </b>Youth randomized to Healthy Choices showed a significant decline in viral load at 6 months postintervention compared with youth in the control condition (beta = -0.36, t = -2.15, P = .03), with those prescribed antiretroviral medications showing the lowest viral loads. Differences were no longer significant at 9 months.</p><p><b>CONCLUSION: </b>A motivational interviewing intervention targeting multiple risk behaviors resulted in short-term improvements in viral load for youth living with HIV. Trial Registration clinicaltrials.gov Identifier: NCT00103532.</p>

DOI10.1001/archpediatrics.2009.212
Alternate JournalArch Pediatr Adolesc Med
PubMed ID19996045
PubMed Central IDPMC2843389
Grant ListU01 HD040474 / HD / NICHD NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States
U01 HD040533-01 / HD / NICHD NIH HHS / United States
U01-HD040533 / HD / NICHD NIH HHS / United States