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SPNS Initiative: Assessing Existing Efforts to Increase Adherence to Medication, 1998-2003


This Special Projects of National Significance (SPNS) initiative goal was to assess innovative interventions to increase adherence to  antiretroviral treatment (ART) among underserved populations. The twelve clinic-based demonstration projects were already engaged in delivering HIV primary care to underserved populations, and they had fully operational adherence support programs for their clients receiving ART. The grant recipients were funded to evaluate their adherence programs based upon their innovative approaches. The programs served a variety of populations, but all targeted uninsured or underinsured people living with HIV who had difficulty accessing care. The programs used a range of different adherence interventions, but all sought to improve the ability of their clients to successfully adhere to ART. No clients were prevented from receiving the services of their programs if they choose not to participate in the study.

The New York Academy of Medicine served as the Center for Adherence Support Evaluation (CASE) for this SPNS initiative. Demonstration project recipients included: the Health Services Center (Anniston, AL); Chase Brexton Health Services (Baltimore, MD); Columbia University Harlem Hospital Center (New York, NY); Columbia University School of Public Health (New York, NY); Dimock Community Health Center (Roxbury, MA); Johns Hopkins University School of Medicine (Baltimore, MD); Mission Neighborhood Health Center (San Francisco, CA); Multnomah County Health Department (Portland, OR); New York State Health Department (AIDS Institute, Renssalaer, NY); North Broward Hospital District (Fort Lauderdale, FL); University of California, San Francisco; and Washington University (St. Louis, MO).

Journal Articles

Mannheimer SB, Mukherjee R, Hirschhorn LR, Dougherty J, Celano SA, Ciccarone D, Graham, KK, Mantell JE, Mundy LM, Eldred L, Botsko M, & Finkelstein R. The CASE adherence index: A novel method for measuring adherence to antiretroviral therapy. AIDS Care, October 2006; 18 (7): 853-861. PubMed Abstract

Weiss L, French T, Waters M, Netherland J, Agins B, & Finkelstein R. Adherence to HAART: Perspectives from clients in treatment support programs. Psychology, Health & Medicine, May 2006; 11 (2): 155-170. PubMed Abstract

Schackman BR, Finkelstein R, Neukermans CP, Lewis L, Eldred L, and the Center For Adherence Support and Evaluation Team. The cost of HIV medication adherence support interventions: Results of a cross-site evaluation. AIDS Care, November 2005; 17 (8): 927-937. PubMed Abstract

French T, Weiss L, Waters M, Tesoriero J, Finkelstein R, & Agins B. Correlation of a Brief Perceived Stress Measure with Nonadherence to Antiretroviral Therapy Over Time. Journal of Acquired Immune Deficiency Syndromes, April 2005; 38 (5): 590-597. PubMed Abstract

The Center for Adherence Support Evaluation (CASE).  Cross-Site Evaluation as a Methodology: The Case of Antiretroviral Adherence Support Interventions, 2004.  Full text Report

Weiss L, French T, Finkelstein R, Waters M, Mukherjee R, & Agins B. HIV-related knowledge and adherence to HAART. AIDS Care, October 2003; 15 (5): 673-679. PubMed Abstract

Tesoriero J, French T, Weiss L, Waters M, Finkelstein R, & Agins B. Stability of adherence to highly active antiretroviral therapy over time among clients enrolled in the treatment adherence demonstration project. Journal of Acquired Immune Deficiency Syndromes, August 2003; 33 (4): 484-493. PubMed Abstract

SPNS Funding Opportunities
- No current funding opportunities.