A Randomized Trial of a Nursing Intervention for HIV Disease Management Among Persons With Serious Mental Illness

Michael B. Blank*, Nancy P. Hanrahan, Martin Fishbein, Evan S. Wu, Julie A. Tennille, Thomas R. Ten Have, Ann M. Kutney-Lee, Robert Gross, Janet M. Hines, James C. Coyne, Linda H. Aiken

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

20 Citations (Scopus)

Abstract

Objective: The heightened risk of persons with serious mental illness to contract and transmit HIV is recognized as a public health problem. Persons with HIV and mental illness may be at risk for poor treatment adherence, development of treatment-resistant virus, and worse outcomes. The objective of this study was to test the effectiveness of a community-based advanced practice nurse (APN) intervention (PATH, Preventing AIDS Through Health) to promote adherence to HIV and psychiatric treatment regimens. Methods: Community-dwelling HIV-positive participants with co-occurring serious mental illnesses (N=238) were recruited from community HIV provider agencies from 2004 to 2008 to participate in the randomized controlled trial. Participants in the intervention group (N=128) were assigned an APN who provided community-based care management at a minimum of one visit per week and coordinated clients' medical and mental health care for one year. Viral load and CD4 cell count were evaluated at baseline and 12 months. Results: Longitudinal models for continuous log viral load showed that compared with the control group, the intervention group exhibited a significantly greater reduction in log viral load at 12 months (d=-.361 log 10 copies per milliliter, p

Original languageEnglish
Pages (from-to)1318-1324
Number of pages7
JournalPsychiatric Services
Volume62
Issue number11
Publication statusPublished - Nov-2011
Externally publishedYes

Keywords

  • CD4 CELL COUNT
  • ADHERENCE INTERVENTION
  • ANTIRETROVIRAL THERAPY
  • MEDICATION ADHERENCE
  • SUBSTANCE-ABUSE
  • HEALTH
  • LOAD

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