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P073 Do financial incentives (FI) and motivational interviewing (MI) promote adherence in vertically infected HIV positive adolescents?
  1. Asad Charania1,
  2. Helen Webb2,
  3. David Cox2,
  4. Charlotte Jackson2,
  5. Katia Prime2
  1. 1St George’s University of London, London, UK
  2. 2St George’s University NHS Foundation Trust, London, UK

Abstract

Introduction Funding was received for 10 patients to participate in a FI & MI scheme aiming to achieve viral load (VL) reduction.

Methods Eligibility criteria: 16-25 years, vertically acquired HIV-1 infection, CD4 <350 cells/ul, agrees to ART with treatable virus, poor adherence since diagnosis & failure to achieve VL <40 copies/ml. FIs received for VL reductions ≥ 1 log weeks 2 & 4 and VL <40 week 8, 3/12, 6/12, 9/12 and 1 year. £20 given for VL reduction ≥ 1 log and £50 for VL <40. Adherence support with motivational interviewing (MI) was provided at each visit.

Results 8 patients enrolled 1/8/12–1/12/15. 5 females, median age 24 years (range 20–26). Mean baseline VL 35750, this reduced to 1390 (mean VL reduction 21842 copies/ml). 5/8 patients achieved VL <40. N=1 had never achieved VL <40, yet during the scheme achieved VL <40 for 8/12. 3 patients were unable to achieve VL <40. Their lowest VL was 71, 883 and 90, representing a 1–2 log VL drop from baseline after 52/12, 4/12 and 1/12, respectively. 1 patient passed away following a Steven-Johnson reaction, never achieving VL <40. Financial incentives given totalled £640.

Discussion Despite widely available treatment options for HIV, preventable deaths still occur each year due to a lack of adherence. Within this cohort, 5 patients were able to achieve periods of VL <40 after years of detectability. These results highlight that FI in conjunction with MI, may have a role in improving adherence for the adolescent HIV infected population.

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