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HORIZONS PROJECT
Reducing Drop-outs and Increasing Adherence Rates Among People Living with
HIV/AIDS on Highly Active Antiretroviral Therapy in
Northern Thailand
A situation analysis conducted soon after the national antiretroviral therapy (ART) program had begun in Thailand indicated a high drop-out rate among patients, gaps in providers’ abilities and confidence to manage patients, and barriers to adherence.
In response, this study is evaluating the use of practical treatment guidelines for providers and a strengthened clinic-counseling intervention to reduce dropouts and to promote short- and long-term treatment adherence. The research also is examining the added value of a peer component: Some of the health services are offering monthly peer group education sessions at the clinic, peer outreach education, and follow-up in the community. Study partners include the AIDS, STD and TB Bureau of the Thai Ministry of Health; the Department of Psychiatry, Faculty of Medicine, Chiang Mai University; and the Research Institute for Health Sciences, Chiang Mai University.
The counseling intervention is divided into three phases. The preparation phase is conducted before people living with HIV/AIDS begin taking medication; the initial phase includes weekly counseling during the first month; and the maintenance phase will include counseling integrated into the clinic’s routine work. Family involvement is integrated throughout the counseling process. Furthermore, modules, training, and tool kits to promote adherence to HIV treatment have been developed.
The study is taking place in one provincial and 44 district hospitals in northern Thailand. Each of the three arms of the study has been randomly assigned 15 hospitals. The arms include:
-
Arm I: practical guidelines and the adherence-counseling program
-
Arm II: same as Arm I but with a peer-based intervention added
- Arm III: standard care (control)
Three waves of data collection have been undertaken, and quantitative and qualitative data from respondents in the three arms are being compared to determine the impact of the interventions. Final results will be available in late 2007.
Location
Northern Thailand
Duration
November 2003–May 2007
Horizons and Population Council researchers
Avina Sarna, Naomi Rutenberg, Philip Guest
Non-Council collaborators
Center for Disease Prevention and Control, Region 10
Sombat Tapanya (Department of Psychiatry, Faculty of Medicine, Chiang Mai University)
Suwat Chariyalertsak (Research Institute for Health Sciences, Chiang Mai University)
Taweesap Siraprapasiri (AIDS Division, Ministry of Public Health)
Sombat Thanprasertsuk (AIDS, TB and STD Bureau, Ministry of Public Health)
Northern NGO Coalition on AIDS
Upper Northern Thai Network of People Living with HIV/AIDS
Donors
US Agency for International Development
Department of Psychiatry, Chiang Mai University
Publications/Resources
Horizons and Population Council researchers' names appear in
boldface type.
2004
Panpanich, Ratana et al. 2004. “A rapid situation analysis of the
Access to Care project in northern Thailand,” Horizons Final Report.
Washington, DC: Population Council. (PDF)
Related Project
See Also
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Publications/Resources |
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"A rapid situation analysis of the access to care project in northern Thailand" (2004) (PDF) |