Compliance study launches at Thomas Street Clinic. (Clinical Trial Information).

Even though HIV disease has become a "chronic" disease, it is unlike many other chronic disease states (such as hypertension and diabetes) because compliance in HIV care has unparalleled social and public health influences. Many factors interfere with compliance, including continued substance

abuse, competing subsistence needs (like housing, clothing, etc.), difficulties in accessing care, and poor support from peer groups, employers, and family members. All of these factors lead to failure to come for scheduled clinic appointments and to refill prescriptions on time. Thus, overall compliance is poor, which will likely limit options for future therapy, worsen disease outcome, and possibly even increase the potential for transmitting drug-resistant virus.

A new study is being launched at Houston's Thomas Street Clinic to look at interventions that might improve compliance among women in traditionally underserved populations. A grant for $243,000 was generously awarded by Bristol Myers Squibb to fund the project. Dr. Fehmida Visnegarwala, Director of Education at Thomas Street Clinic and an assistant professor of medicine at Baylor College of Medicine, will oversee the study.

The study proposes to establish a quality improvement program for 100 women followed for an average of 18 months in an attempt to increase compliance with clinic visits and anti-HIV medications. This will be accomplished by providing patients with sufficient understanding of

* the basic biology of HIV infection,

* the effects and limitations of presently available anti-HIV drugs, and

* the best ways to use health care resources to maximize response to therapy.

For those participants identified with active drug use, effective drug-rehabilitation services will be provided. The study will test if an intensive early-intervention program will give patients the desire and skills needed to use the health care delivery system to their best advantage. Women receiving care at Thomas Street Clinic are eligible to enroll in this study. For more information, contact Mary Caprio (713-873-4185).