title: Two strategies to increase adherence to HIV antiretroviral medication: life-steps and medication monitoring.
abstract: Advances in the medical treatment of HIV have made it clear that adherence to highly active antiretroviral treatment is a crucial feature for treatment success. The present paper had two goals: (1) to examine psychosocial predictors of adherence in persons receiving HIV antiretroviral therapy; (2) to compared two minimal-treatment interventions to increase HIV medication adherence in a subset of persons who self-reported less than perfect adherence. One of the interventions, Life-Steps, is a single-session intervention utilizing cognitive-behavioral, motivational interviewing, and problem-solving techniques. The other intervention, self-monitoring, utilizes a pill-diary and an adherence questionnaire alone. Significant correlates of adherence included depression, social support, adherence self-efficacy, and punishment beliefs about HIV. Depression was a significant unique predictor of adherence over and above the other variables. Both interventions yielded improvement in adherence from baseline, and the Life-Steps intervention showed faster improvements in adherence for persons with extant adherence problems.
authors.affiliation: Massachusetts General Hospital and Harvard Medical School, Boston MA 02114, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Safren
authors.forename: M W
authors.initials: MW
authors.lastname: Otto
authors.forename: J L
authors.initials: JL
authors.lastname: Worth
authors.forename: E
authors.initials: E
authors.lastname: Salomon
authors.forename: W
authors.initials: W
authors.lastname: Johnson
authors.forename: K
authors.initials: K
authors.lastname: Mayer
authors.forename: S
authors.initials: S
authors.lastname: Boswell
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001521:Behavior Therapy / Q000379:methods*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D016903:Drug Monitoring; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D010865:Pilot Projects; D012307:Risk Factors; D012648:Self Care / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents