Implementation and uptake of the Conexiones y Opciones en la Argentina intervention: feasibility and acceptability

Abstract

Challenging HIV-infected patients, those neither adherent nor actively engaged in care, represent an important opportunity for intervention if the HIV epidemic is to be contained. This pilot study assessed the feasibility and acceptability of an adapted patient adherence intervention and a motivational interviewing-based provider intervention in urban Buenos Aires, Argentina, in order to optimize health benefits in challenging HIV-infected patients. To maximize implementation and uptake of both strategies, interventions were adapted to the local setting. Qualitative data and a short quantitative assessment from patients, staff, fellows, residents and physicians (n = 84) were examined to establish the feasibility and acceptability of offering patient and provider evidence-based interventions in both public and private healthcare settings. Results identified key themes on provision of information, use of specialized communication techniques, and group support in the utilization of the interventions. Both providers (n = 12) and patients (n = 120) endorsed the acceptability and value of the interventions, and the feasibility of their delivery. Findings support the use of both intervention modalities with challenging patients in diverse urban healthcare settings.

A small cluster randomised clinical trial to improve health outcomes among Argentine patients disengaged from HIV care

“…After all, the indirect effects through the patient-physician relationship were enhanced by MI, which in turn were associated with enhanced HIV outcomes. 15 …”

“…Patients with MI-trained physicians also reported greater satisfaction with their patient-physician relationship, expressed greater motivation to optimize treatment behaviours and treatment engagement, and greater willingness to embrace other sources of support. 15 Both patients and physicians preferred a collaborative approach to HIV treatment and care utilizing both the physician’s expertise and the patient’s own experiences. This study team then launched a randomised clinical trial of MI and successfully trained physicians across Argentina to use MI in ongoing clinical practice.…”