Increasing drug users' adherence to HIV treatment

Results of a peer-driven intervention feasibility study

Robert S. Broadhead, Douglas D. Heckathorn, Frederick L. Altice, Yaël Van Hulst, Michael Carbone, Gerald H. Friedland, Patrick G. O'Connor, Peter A. Selwyn

Research output: Contribution to journalArticle

134 Citations (Scopus)

Abstract

Active drug users with HIV infection suffer from both low utilization of, and adherence to, primary care. Combining drug treatment and primary care on-site reduces these problems significantly because it creates a social support structure; treatment program staffs can monitor patients' adherence and provide ongoing encouragement. But in the United States, only a very small minority of HIV+ drug users receive this demonstrably effective form of care. We report the results from a feasibility study of an alternative support structure, termed a "peer-driven intervention", that serves as a functional equivalent to drug treatment for increasing drug users' adherence to HIV therapeutics. The six-month study included 14 adult active drug users receiving medical care for HIV disease in New Haven, Connecticut. As a health advocate, each subject was assigned and asked to meet with another subject once a week at the project's storefront to provide peer support and counseling. As a peer, each subject was assigned and asked to meet with another health advocate once a week to receive support in keeping up his or her medical care. No two subjects played both roles for one another. Advocates earned nominal monetary rewards for eliciting positive responses from their peers in keeping clinical appointments, responding to physicians' referrals, picking up prescriptions on time and attending weekly meetings with the advocate. The results of the study suggest that an alternative social support structure to drug treatment is feasible for increasing active drug users' adherence to medical care. Innovative mechanisms that harness drug users' peer pressure to promote positive behavioral changes deserve greater study.

Original languageEnglish (US)
Pages (from-to)235-246
Number of pages12
JournalSocial Science and Medicine
Volume55
Issue number2
DOIs
StatePublished - 2002

Fingerprint

drug user
Feasibility Studies
human immunodeficiency virus
feasibility study
Drug Users
HIV
drug
support structure
Social Support
medical care
Primary Health Care
Therapeutics
Pharmaceutical Preparations
social support
Health
Patient Compliance
Reward
HIV Infections
Prescriptions
Peers

Keywords

  • Adherence
  • Antiretroviral therapy
  • Health care utilization
  • HIV/AIDS
  • Injecting drug users
  • Intervention
  • Social supports
  • Substance abuse
  • USA

ASJC Scopus subject areas

  • Economics and Econometrics
  • Public Health, Environmental and Occupational Health
  • Social Psychology
  • Development
  • Health(social science)

Cite this

Increasing drug users' adherence to HIV treatment : Results of a peer-driven intervention feasibility study. / Broadhead, Robert S.; Heckathorn, Douglas D.; Altice, Frederick L.; Van Hulst, Yaël; Carbone, Michael; Friedland, Gerald H.; O'Connor, Patrick G.; Selwyn, Peter A.

In: Social Science and Medicine, Vol. 55, No. 2, 2002, p. 235-246.

Research output: Contribution to journalArticle

Broadhead, RS, Heckathorn, DD, Altice, FL, Van Hulst, Y, Carbone, M, Friedland, GH, O'Connor, PG & Selwyn, PA 2002, 'Increasing drug users' adherence to HIV treatment: Results of a peer-driven intervention feasibility study', Social Science and Medicine, vol. 55, no. 2, pp. 235-246. https://doi.org/10.1016/S0277-9536(01)00167-8
Broadhead, Robert S. ; Heckathorn, Douglas D. ; Altice, Frederick L. ; Van Hulst, Yaël ; Carbone, Michael ; Friedland, Gerald H. ; O'Connor, Patrick G. ; Selwyn, Peter A. / Increasing drug users' adherence to HIV treatment : Results of a peer-driven intervention feasibility study. In: Social Science and Medicine. 2002 ; Vol. 55, No. 2. pp. 235-246.
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