Randomized controlled trial of an intervention to prevent adherence failure among HIV-infected patients initiating antiretroviral therapy.

OBJECTIVE: Compare the efficacy of a multicomponent social support intervention to standard-of-care counseling on medication adherence among HIV-infected patients initiating antiretroviral therapy. DESIGN: Randomized controlled trial. Generalized estimating equations tested for differences in the percentage of participants achieving 90% adherence. MAIN OUTCOME MEASURES: Pill-taking, electronically monitored over 6 consecutive months; plasma viral load (VL), assessed at 3 and 6 months following initiation of therapy. RESULTS: Of 226 participants who were randomized and began the trial, 87 (38%) were lost to the study by 6 months. The proportion of adherent participants declined steadily over time, with no time by group interaction. Sustained adherence was associated with increased odds of achieving an undetectable VL (OR=1.78; 95% CI=1.01, 3.13). In intention-to-treat analyses, a larger proportion of the intervention group than the control group was adherent (40.15% vs. 27.59%, p=.02) and achieved an undetectable VL p=.04). However, the majority of participants who remained on study experienced some reduction in VL (>or=1-log drop or undetectable), regardless of experimental condition. CONCLUSION: The multicomponent social support intervention significantly improved medication adherence over standard-of-care counseling; evidence for improved virologic outcomes was inconsistent. Early discontinuation of care and treatment may be a greater threat to the health of HIV patients than imperfect medication-taking.     

The impact of informant gender on children’s endorsement of scientific and non-scientific information

By roughly 6 years of age, children acquire the stereotype that men are more competent than women in science, technology, engineering, and mathematics (STEM), potentially leading to greater trust in scientific information provided by men. This study tested whether 3- to 8-year-old children differentially endorsed conflicting information about science and toys presented by male and female informants depicted as a ‘man’ and ‘woman’ (Exp1) or ‘scientists’ (Exp2). Children were expected to endorse toy testimony from gender-matched informants; thus, the key question concerned endorsement of science testimony. In Exp1 (N = 149), boys and girls showed a same-gender informant preference for toy testimony; however, girls endorsed the male informant's testimony more for science than for toys – but only when tested by a male experimenter. In Exp2 (N = 264), boys and girls showed a same-gender preference, irrespective of content. Findings suggest that STEM-related gender stereotypes might lead girls to trust scientific information presented by men over women in certain contexts.     

Bidirectional Familial Influences in Dietary Behavior Test of a Model of Campaign Influences

Using both cross-sectional and longitudinal data spanning a decade, this article analyzes how dietary behavior of household children and adults (N = 576 households) was affected by the Stanford Five-City Project (FCP). Tests of a three-part, cumulative model of bidirectional influences within the family, which conceptualizes household members as sources of influence on each other and subject to influence by an external agent, were supported. Children and adults were influenced by both each other and the FCP campaign in changing and maintaining health behaviors. This article demonstrates that public health campaigns can be made more effective if they conceptualize both children and adults as potential sources of influence. The long-term effectiveness of such efforts can be enhanced by encouraging families, as opposed to individuals, to change health behaviors.     

Perceptual learning in maze discriminations

In Experiment 1, rats were trained on a discrimination between rubber- and sandpaper-covered arms of a maze after one group had been pre-exposed to these intra-maze cues. Pre-exposure facilitated subsequent discrimination learning, unless the discrimination was made easier by adding further discriminative stimuli, when it now significantly retarded learning. In Experiment 2, rats were trained on an extra-maze spatial discrimination, again after one group, but not another, had been pre-exposed to the extra-maze landmarks. Here too, pre-exposure facilitated subsequent discrimination learning, unless the discrimination was made substantially easier by arranging that the two arms between which rats had to choose were always separated by 135°. The results of both experiments can be explained by supposing that perceptual learning depends on the presence of features common to S+ and S-.