An integrated approach for antiretroviral adherence and secondary HIV transmission risk-reduction support by nurses in Kenya

J Assoc Nurses AIDS Care. 2012 Mar-Apr;23(2):146-54. doi: 10.1016/j.jana.2011.05.001. Epub 2011 Jul 30.

Abstract

Ongoing antiretroviral therapy (ART) adherence and secondary HIV transmission-risk reduction (positive prevention) support are needed in resource-limited settings. We evaluated a nurse-delivered counseling intervention in Kenya. We trained 90 nurses on a brief counseling algorithm that comprised ART and sexual-risk assessment, risk-reduction messages, and health-promotion planning. Self-reported measures were assessed before, immediately after, and 2 months post-training. Consistent ART adherence assessment was reported by 29% of nurses at baseline and 66% at 2 months post-training (p < .001). Assessment of patient sexual behaviors was 25% at baseline and 60% at 2 months post-training (p < .001). Nurse practice behaviors recommended in the counseling algorithm improved significantly at 2 months post-training compared with baseline, odds ratios 4.30-10.50. We found that training nurses in clinical counseling for ART adherence and positive prevention is feasible. Future studies should test impact of nurse counseling on patient outcomes in resource-limited settings.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Antiretroviral Therapy, Highly Active / nursing
  • Counseling*
  • Delivery of Health Care, Integrated
  • Feasibility Studies
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / nursing*
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Inservice Training
  • Kenya
  • Male
  • Medication Adherence*
  • Nursing Staff / education*
  • Pilot Projects
  • Risk Reduction Behavior*
  • Safe Sex