April 6, 2011

Dear Colleague:

Adherence to antiretroviral therapy (ART) among people living with HIV infection is critical for treatment success and HIV prevention. As we continue our efforts to optimize health outcomes for individuals living with HIV, the Centers for Disease Control and Prevention (CDC)—with support from adherence experts as well as scientists at the Health Resources and Services Administration, the National Institute of Mental Health, and the National Institute on Drug Abuse —is pleased to announce that we have identified eight evidence-based interventions focusing on medication adherence that improve medication adherence behaviors and viral suppression. The interventions are described in a new medication adherence chapter that has been added to the Compendium of Evidence-Based Behavioral Interventions. The adherence interventions focus on educating and motivating patients, building patients’ skills, providing tools for better medication management and ongoing support, and addressing other issues that may act as barriers to adherence.

Increasing access to care and optimizing health outcomes for individuals living with HIV is one of the three primary goals of the National HIV/AIDS Strategy. Suboptimal adherence is strongly associated with treatment failure including increased mortality, viral resistance, limited future treatment options and increased risk of HIV transmission to others. To help patients benefit fully from ART, clinicians should take time to ask about and support medication adherence, and implement evidence-based intervention strategies whenever possible.

Since 1996, the Prevention Research Synthesis (PRS) team in the Division of HIV/AIDS Prevention at CDC has been conducting systematic efficacy reviews focused on interventions to address sex and drug behaviors related to HIV acquisition and transmission. Building on these efforts to identify scientifically proven prevention interventions, the team expanded the scope of its work in 2008 to include interventions to improve medication adherence behaviors and outcomes. The systematic review process begins with a comprehensive search of the published scientific literature to identify evaluation studies of medication adherence interventions. The team then reviews each intervention evaluation study using explicit criteria assessing quality of study design, implementation, analytic methods, and strength of findings to identify interventions with the strongest evidence of efficacy. Descriptions of these eight medication adherence evidence-based behavioral interventions, along with the review methods and efficacy criteria for new interventions, are all integrated into a new medication adherence chapter within the Compendium of Evidence-Based Behavioral Interventions on CDC’s PRS Project website. PRS is continually reviewing the literature and will update this website annually to provide timely information to the prevention field.

We will be working with our federal partners to identify the best way to turn these evidence-based interventions into tools or packages for practice. Although national product dissemination will not occur for some time, updated information will be provided as it becomes available on our web site.

With your continued support, we can help people with HIV live longer healthier lives and improve HIV prevention. I appreciate your commitment to HIV prevention and treatment.

Sincerely,

/Jonathan H. Mermin/

Jonathan H. Mermin, MD
Director
Division of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention