To promote HIV antiretroviral therapy (ART) outcomes in Haiti, we developed a culturally relevant intervention (InfoPlus Adherence) that combines an electronic medical record alert identifying patients at elevated risk of treatment failure and provider-delivered brief problem-solving counseling. We conducted a quasi-experimental mixed-methods study among 146 patients at two large ART clinics in Haiti with 728 historical controls. We conducted quantitative assessments of patients at baseline and intervention completion (6 months) as well as focus groups with health workers and exit interviews with patients. The primary quantitative outcome measures were HIV viral suppression according to medical record and ART adherence in terms of ≥ 90% for “proportion of days covered” (PDC) according to pharmacy dispensing data. Results indicated that the proportion of intervention patients with suppressed VL during the study/historical periods was 80.0%/86.0% and 76.8%/87.4% for controls. In a difference-in-differences (DID) analytic model, the adjusted relative risk for viral suppression with the intervention was 1.15 (95% CI 0.92–1.45, p = 0.21), representing favorable but non-significant association between the intervention and the trajectory of VL outcomes. PDC ≥ 90% during the study/historical periods was 30.9%/11.0% among intervention participants and 16.9%/19.4% among controls. In the adjusted DID model, the relative risk for of PDC ≥ 90% with the intervention was 4.00 (95% CI 1.91–8.38, p < 0.001), representing a highly favorable association between the intervention and the trajectory of PDC outcomes. Qualitative data affirmed acceptability of the intervention, although providers reported some challenges consistently implementing it. Future research is needed to demonstrate efficacy and explore optimal implementation strategies.

为了在海地促进 HIV 抗逆转录病毒治疗 (ART) 结果，我们开发了一种与文化相关的干预措施 ( InfoPlus Adherence) 结合了电子病历警报，识别治疗失败风险较高的患者，以及提供者提供的简短问题解决咨询。我们在海地的两家大型 ART 诊所的 146 名患者中进行了一项准实验性混合方法研究，其中有 728 名历史对照。我们对基线和干预完成（6 个月）的患者以及与卫生工作者的焦点小组进行了定量评估，并与患者进行了离职面谈。根据药房配药数据，主要定量结果指标是根据医疗记录的 HIV 病毒抑制和 ART 依从性≥90% 的“覆盖天数比例”（PDC）。结果表明，在研究/历史期间，VL 抑制的干预患者比例为 80.0%/86.0%，对照组为 76.8%/87.4%。在差异差异 (DID) 分析模型中，干预后病毒抑制的调整后相对风险为 1.15（95% CI 0.92–1.45，p = 0.21），代表干预与VL 结果的轨迹。在研究/历史期间，PDC ≥ 90% 在干预参与者中为 30.9%/11.0%，在对照组中为 16.9%/19.4%。在调整后的 DID 模型中，干预后 PDC ≥ 90% 的相对风险为 4.00（95% CI 1.91–8.38，p < 0.001），表明干预与 PDC 结果轨迹之间存在高度有利的关联。定性数据证实了干预的可接受性，尽管提供者报告了一些持续实施干预的挑战。