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<p>The use of antiretroviral drugs has been proven effective in preventing and treating HIV; however, adherence remains a challenge. In two parallel pilot studies, we implemented a combination adherence intervention involving patient-centered counseling and adherence supporter training, tailored for HIV treatment (ART) or prevention (PrEP) during pregnancy and breastfeeding. The intervention included Integrated Next Step Counseling (iNSC), focused on well-being and medication adherence, with an option to involve a social support member. Independent auditors assessed implementation fidelity for 151 participants (51 women living with HIV and 100 PrEP-eligible women) by scoring iNSC sessions using a standard checklist. High fidelity was observed overall in both study populations, with variability between counselors observed. The results demonstrate the ability to assess implementation fidelity in a behavioral intervention aimed at supporting adherence to antiretroviral drugs among pregnant women and offers critical information on the complexities of implementation of iNSC in a real-world setting.</p>

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Assessing the Implementation Fidelity of a Patient-Centered, Combination Adherence Strategy to Support HIV Antiretroviral Therapy and Pre-Exposure Prophylaxis Adherence During Pregnancy and Breastfeeding in Malawi

  • 期刊论文

  • 发表日期：

    2025年4月24日

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  • Friday Saidi,
  • Lauren A. Graybill,
  • Twambilile Phanga,
  • Katie R. Mollan,
  • Getrude Msowoya,
  • Mercy Tsidya,
  • Mary Chindevu,
  • Donnie Makonokaya,
  • Kellie Freeborn,
  • Nora E. Rosenberg,
  • Lauren M. Hill,
  • Sam Phiri,
  • Wilbroad Mutale,
  • Benjamin H. Chi,
  • K. Rivet Amico

摘要

The use of antiretroviral drugs has been proven effective in preventing and treating HIV; however, adherence remains a challenge. In two parallel pilot studies, we implemented a combination adherence intervention involving patient-centered counseling and adherence supporter training, tailored for HIV treatment (ART) or prevention (PrEP) during pregnancy and breastfeeding. The intervention included Integrated Next Step Counseling (iNSC), focused on well-being and medication adherence, with an option to involve a social support member. Independent auditors assessed implementation fidelity for 151 participants (51 women living with HIV and 100 PrEP-eligible women) by scoring iNSC sessions using a standard checklist. High fidelity was observed overall in both study populations, with variability between counselors observed. The results demonstrate the ability to assess implementation fidelity in a behavioral intervention aimed at supporting adherence to antiretroviral drugs among pregnant women and offers critical information on the complexities of implementation of iNSC in a real-world setting.