XVIII International AIDS Conference


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Early alert system and systemic response to antiretroviral treatment adherence

A. Jimenez1, K. Boryc2, J. Kerr2

1Cicatelli Associates Inc., International Division, New York, United States, 2Cicatelli Associates Inc., New York, United States

Issues: Treatment adherence remains a problem in HIV prevention globally. A major challenge is the lack of systems-level interventions that help identify clients who are at risk of non-adherence before it happens. Identifying and addressing contributing factors to non-adherence can save time and resources by getting appropriate services to the client and helping avoid interruptions in treatment, resulting in improved quality of care and resource savings.
Description: Cicatelli Associates Inc. developed the Early Alert Intervention (EAI), a systems-level intervention for using key indicators to identify clients who are at risk of becoming non-adherent to treatment and care. EAI is composed of four components: identify and recognize the EA indicators; identify an intervention plan; monitor implementation of the intervention plan; and reassess the indicators. Inclusion of all members of the multidisciplinary team in implementing EAI, establishing a clear communication system, and integrating the program into existing systems where possible are crucial for success. EAI is being piloted in five Integral Care clinics of the Dominican Republic, using an action learning approach to ensure rapid adoption and utilization.
Lessons learned: Gaining buy-in and leadership from Ministry of Health supervisory and senior staff has been essential to ensuringnrollout of the pilot. Integrating peers into the multidisciplinary team proved a successful model for identifying Early Alert indicators and providing follow-up to implementation of intervention plans.
Next steps: Early evaluation findings on EAI implementation in clinic sites across the USA have been very promising. Replication of EAI in the Dominican Republic, using an action learning approach, will provide a model for its dissemination globally. An action learning approach is one in which participants are actively involved in the learning process, studying their actions and experiences to adjust future actions, improve performance, all while continuing to implement services.

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