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Peer Support and Pager Messaging to Promote Antiretroviral Modifying Therapy in Seattle: A Randomized Controlled Trial
Open accessAbstract
OBJECTIVE: To determine the relative efficacy of peer support and pager messaging strategies versus usual care to improve medication adherence and clinical outcomes among HIV-positive outpatients initiating or switching to a new highly active antiretroviral therapy regimen. DESIGN: A 2 3 2 factorial randomized controlled trial of a 3-month intervention with computer-assisted self-interviews and blood draws administered at baseline, 3, 6, and 9 months. METHODS: HIV-positive patients at a public HIV specialty clinic in Seattle,WA (N = 224) were randomly assigned to peer support, pager messaging, both strategies, or usual care. The main outcomes were adherence according to self-report and electronic drug monitoring, CD4 count, and HIV-1 RNA viral load. RESULTS: Intent-to-treat analyses suggested the peer intervention was associated with greater self-reported adherence at immediate postintervention. However, these effects were not maintained at follow-up assessment; nor were there significant differences in biological outcomes. The pager intervention, on the other hand, was not associated with greater adherence but was associated with improved biological outcomes at postintervention that were sustained at follow-up. CONCLUSIONS: Analyses indicate the potential efficacy of peer support and pager messaging to promote antiretroviral adherence and biological outcomes, respectively. More potent strategies still are needed.
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“This intervention, however, failed to produce significant improvements in adherence over the 9-month trial relative to usual care or peer support”
From Health behavior models in the age of mobile interventions: are our theories up to the task? (2011) · cites this paper as [55]
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Longitudinal data analysis using generalized linear models
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MethodSelf-citationThe Survival Benefits of AIDS Treatment in the United States
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BackgroundAddressing the Challenges of Adherence
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“Consistent strict adherence remains key to successful viral suppression.(4) However, in both resource-rich and resource-constrained settings, the majority of patients on HAART struggle to maintain optimal levels of adherence.”
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on behalf of the NYLinks Implementation Team, Addison, D., Baim‐Lance, A. M., Suchman, L., Katz, B., Swain, C.-A. E., Piersanti, K., Steinbock, C., Sawicki, S., Agins, B., et al. (2018) · AIDS and Behavior · doi:10.1007/s10461-018-2060-2 · Cited by 17
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PrEP Implementation Science: State-of-the-Art and Research Agenda
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“Data for the present study derived from a prior randomized controlled trial evaluating peer support and pager text messaging to promote adherence (Simoni et al., 2009), in which participants were recruited from a primary care HIV clinic using advertisements, provider referral, and a nurse dedicated to recruitment.”
MethodSelf-citationChen, Y.-H., Farnham, P. G., Hicks, K. A., & Sansom, S. L. (2021) · Journal of Public Health Management and Practice · doi:10.1097/phh.0000000000001397 · Cited by 14
Innovating access to the nurse-led hepatitis C clinic using co-production
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“In keeping with the literature for HCV and other conditions such as substance misuse and HIV, the use of buddies or ‘peer support’ was suggested by the participants as a strategy that may help improve engagement with the clinic (Kulik and Shah, 2016; Simoni et al., 2009).”
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Self-citationWali, N., Renzaho, A. M. N., Wang, X., Atkins, B., & Bhattacharya, D. (2020) · AIDS Care · doi:10.1080/09540121.2020.1811198 · Cited by 12
“sex, and sexual orientation (Simoni et al., 2007; Simoni et al., 2009); and included patient participation in the intervention (Moore et al.”
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Revising the American dream: how Asian immigrants adjust after an HIV diagnosis
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“The HIV-positive individuals in this study talked about resources that decreased acculturation stress and most prominent among these resources was support from HIV healthcare providers and peers (Simoni et al. 2009, Simoni et al. 2011).”
BackgroundZoungrana-Yameogo, W. N., Fassinou, L. C., Ngwasiri, C., Samadoulougou, S., Traoré, I. T., Hien, H., Bakiono, F., Drabo, M., & Kirakoya‐Samadoulougou, F. (2022) · Patient Preference and Adherence · doi:10.2147/ppa.s354242 · Cited by 11
“The effect does not persist when the support is discontinued.(37,38) This suggests that communication strategies to demonstrate the positive effect of continued participation in support groups must be established and actors that lead these groups should be aware of the importance of communication and improve their mes…”
BackgroundMedication delivery factors and adjuvant endocrine therapy adherence in breast cancer
Neuner, J. M., Fergestrom, N. M., Pezzin, L. E., Laud, P. W., Ruddy, K. J., & Winn, A. N. (2022) · Breast Cancer Research and Treatment · doi:10.1007/s10549-022-06704-2 · Cited by 13
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“For people living with HIV, matching patients with a peer who shares key characteristics or experiences has been shown to improve HIV knowledge and antiretroviral treatment attitudes and decrease substance use [17-20].”
BackgroundSelf-citationA collaborative awareness system for chronic disease medication adherence applied to HIV infection
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Prevention and Treatment of HIV/AIDS Among Drug-Using Populations: A Global Perspective
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BackgroundFamilies and HIV Medication Adherence
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“Automated systems cannot address structural barriers by themselves but do present opportunities for task-shifting which could free time providers spend on adherence assessment during patient encounters to be instead devoted to addressing barriers to ART adherence [33].”
BackgroundHealthcare professional perspectives on medication challenges in the post-stroke patient
Bell, S., Kelly, H., Hennessy, E., Bermingham, M., O’Flynn, J. R., & Sahm, L. J. (2023) · Frontiers in Pharmacology · doi:10.3389/fphar.2023.1266277 · Cited by 6
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“For instance, one United States-based study found that social network characteristics, such as size and density, are associated with medication adherence among people living with HIV [28].”
BackgroundEfficacy of CHAMPS for Improving Viral Suppression: A Randomised Clinical Trial
Schnall, R., Jia, H., Brin, M., Kay, E. S., Wood, O. R., Abua, J., & Batey, D. S. (2025) · AIDS and Behavior · doi:10.1007/s10461-025-04811-x · Cited by 5
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“Among these three technology-enabled RCT ’ s, the control arms varied: one provided standard of care approaches encompassing adherence education and health system engagement [50], the second, general health and well-being counseling [52], and the last, an animated tutorial on ART adherence [51].”
BackgroundGraff, N. R., Hong, C., Guthrie, B. L., Micheni, M., Chirro, O., Wahome, E., van der Elst, E., Sanders, E. J., Simoni, J. M., & Graham, S. M. (2023) · AIDS and Behavior · doi:10.1007/s10461-023-04027-x · Cited by 5
“were experienced in taking ART, were trained to provide informational, empathetic and motivational support, to encourage regular ART adherence and help address barriers to adherence [15].”
Self-citationImpact of COVID-19 on Adherence to Treatment in Patients with HIV
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Additional Literature Cited: Individual Text Message Intervention Studies in Table 2
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“This statement can also be linked to the analysis of education in this study that education has no significant difference, because education itself has a short effect compared to interactions with peer support [25].”
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“First, strengthen self-efficacy through peer-led demonstrations, practice opportunities, and timely behavioral prompts, with emphasis on populations with lower education and income [51].”
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Metadata
- Authors
- Simoni, J. M., Huh, D., Frick, P. A., Pearson, C. R., Andrasik, M. P., Dunbar, P. J., & Hooton, T. M.
- Affiliations
- University of Washington (US)
- University of Miami (US)
- Corresponding author
- Simoni, Jane M
- Huh, David
- Venue
- JAIDS Journal of Acquired Immune Deficiency Syndromes
- Published
- 2009-12
- Volume
- 52
- Issue
- 4
- Pages
- 465-473
- ISSN
- 1525-4135 (ISSN-L)
- PMC
- PMC2795576
- OpenAlex
- W2065765677
- Cited by
- 174
- References
- 21
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 6 · 2022: 12 · 2021: 5 · 2020: 10 · 2019: 7 · 2018: 14 · 2017: 12 · 2016: 15 · 2015: 17 · 2014: 7 · 2013: 20 · 2012: 15
- FWCI
- 8.85
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAIDS Journal of Acquired Immune Deficiency Syndromes (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH058986)
- National Institute of Allergy and Infectious Diseases (P30AI027757)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- peer support, antiretroviral therapy, medication adherence, HIV, highly active antiretroviral therapy, CD4 count, HIV-1 viral load, HIV outpatients, intervention efficacy
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Patient Compliance, Peer Group, Social Support, HIV Infections, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, Computers, Handheld, Young Adult
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