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 The study results were presented at the 10th International Conference on HIV Treatment and Prevention Adherence in Miami.

The Adherence Improving Self-Management Strategy (AIMS) — designed to equip patients to manage their own behavior — was the result of a collaboration between HIV nurses and patients.

The 223 study participants were recruited from seven HIV clinics in the Netherlands. About half the patients were treatment-experienced, and about half were treatment-naive.

The mean age of the 110 patients randomly assigned to the AIMS intervention was about 45 years. For the other 113 patients, who served as the control group, the mean age was about 43 years.

All but 10 participants completed the trial; mean follow-up was 14.5 months.

At all three follow-up time points, the viral load was 28% higher in the control group than in the intervention group (odds ratio, 1.28; 95% confidence interval [CI], 1.04 - 1.52).

And at the same three follow-up time points, the likelihood that the viral load was undetectable was 89% higher in the intervention group than in the control group (hazard ratio, 1.89; 95% CI, 0.98 - 3.65).

Fewer patients in the intervention group than in the control group had two consecutive detectable viral loads during follow-up (7% vs 17%). In addition, "the effect sizes were similar for ethnic groups and in both treatment-experienced and treatment-naive patients," Dr de Bruin reported.

The cost of the AIMS intervention was only about €83 (US$92) per patient per year, and on all cost-effectiveness analyses, the intervention was cheaper and more effective than treatment as usual.

In this study population, "adherence to care was already fairly comprehensive," Dr de Bruin explained. "This makes it considerably more challenging for any intervention to demonstrate an additional effect."

"In settings with less comprehensive adherence support, the intervention effects would be greater," he added.