An Enhanced Adherence Support Program for HAART

This randomized-controlled study aims to compare the effectiveness of two adherence support strategies for use in patients with HIV-related TB in the context of CAPRISA AIDS Treatment program (CAT) in KwaZulu-Natal, South Africa; the enhanced adherence support program (E-ASP) or the standard adherence support program (S-ASP) used as part of the National roll-out program. The E-ASP program has been designed to be practical within the resource-constrained setting for which this study is planned and uses concepts adapted from Fisher and Fisher's (1992) Information-Motivation-Behavioral Skills (IMB) model of HIV prevention behavior change. It utilizes limited but structured patient-health educator contact, and counseling techniques drawn from motivational interviewing. Adherence assessment at each visit by the study nurse and pharmacist using self-report and pill counts. This will be correlated with viral load and CD4+ T cell count at 2, 3, 12 and 18 months post initiation of ART. These measures are also used to determine treatment success.