363P
BECOMING A TREATMENT SUCCESS: WHAT HELPS AND HINDERS INDIVIDUALS TAKING ANTIRETROVIRAL MEDICATIONS
V Alfonso, J Geller, N Bermbach, JS Montaner
Pacific Region, Canadian HIV Clinical Trials Network, Vancouver, British Columbia
Objectives: The goal of antiretroviral therapy is to achieve and maintain an undetectable plasma viral load. Research on HAART has focused on identifying variables associated with sub-optimum clinical outcomes; less attention has focused on factors associated with successful treatment in general, and higher adherence in particular. As such, little is known about the experiences of individuals who are successful on therapy. The present study used a qualitative method to explore how individuals who have maintained undetectable viral loads account for their clinical success, and to identify challenges, as well as possible needs, for continued success.
Methods: Participants were 20 patients at an outpatient clinic in an urban centre. Participants completed two 60-minute interviews. The Critical Incident Technique was used to identify critical incidents, categories, and sub-categories.
Results: Of the 438 critical incidents collected, 316 were identified as helpful in achieving desired clinical outcomes, and 122 were identified as unhelpful. Helpful categories included resolving ambivalence about living with HIV, social support, and using personal strengths. Unhelpful categories were depressed mood, financial difficulties, medication factors, and lack of social support.
Conclusions: This study provides a detailed description of what has helped a group of individuals achieve and maintain undetectable viral loads. Participant responses reveal the importance of interpersonal support and personal strengths in the ongoing struggle not only to adhere to medications, but to maintain physical and mental health in general. The results of this study place specific health behaviors in the broader context of an individual's mental, physical, and spiritual experiences.