Just saw this Times piece on Truvada, which can protect people (gay men, in this particular study) from contracting AIDS. This is huge news! Even though the rate of new infection is down, there are still more than 2.5 million new cases every year. Many of those are people who don’t have the option of condoms, but might be able to use a method that is more completely in their control. (For example, vaginal microbicides can be effective for women whose partners refuse to wear condoms.)
Of course, Truvada is only effective if you actually take the damn pill – which is something we know many people won’t do, if left to themselves. This has the potential to be a low-hanging fruit intervention right here. We know that simple techniques, like texting people and reminding them to take their pills, can be enormously effective in boosting compliance. However, the most effective interventions would be tied to the reasons why people don’t take their pills.
I’m not an expert on the psychology of compliance, but I suspect that the same motivational ideas we’re building on for the Lit project would apply to medication. People are pretty good about long-term plans without direct feedback when they’re in a telic, or goal-oriented, state of mind. However, people also have other moods: paratelic or playful ones, where they’re much more interested in the immediate. Those are the times when people most need support in carrying through the commitments they made in a telic state of mind – whether that’s quitting smoking or taking their medication or eating healthfully or, well, anything else that requires repeated small decisions to succeed.
All this says to me that medication compliance is low-hanging fruit, where we can have a significant impact with relatively little investment – especially when the medication in question has such high stakes. When I’m done with my dissertation, I’ve got to check out what’s already been done in this field, and see how it can be done better.