Motivational interviewing and cognitive-behavioral intervention to improve HIV medication adherence among hazardous drinkers: a randomized controlled trial.
OBJECTIVE
To assess the efficacy of a behavioral intervention designed to improve HIV medication adherence and reduce alcohol consumption among HIV-positive men and women.


METHODS
A randomized controlled trial conducted between July 2002 and August 2005.


METHODS
A behavioral research center in New York City.


METHODS
HIV-positive men and women (n = 143) who were on HIV antiretroviral medication and met criteria for hazardous drinking.


METHODS
Participants were randomly assigned to an 8-session intervention based on motivational interviewing and cognitive-behavioral skills building or a time- and content-equivalent educational condition.


METHODS
Viral load, CD4 cell count, and self-reported adherence and drinking behavior were assessed at baseline and at 3- and 6-month follow-ups.


RESULTS
Relative to the education condition, participants in the intervention demonstrated significant decreases in viral load and increases in CD4 cell count at the 3-month follow-up and significantly greater improvement in percent dose adherence and percent day adherence. There were no significant intervention effects for alcohol use, however, and effects on viral load, CD4 cell count, and adherence were not sustained at 6 months.


CONCLUSIONS
An 8-session behavioral intervention can result in improvement in self-report and biologic markers of treatment adherence and disease progression. This type of intervention should be considered for dissemination and integration into HIV clinics providing comprehensive care for HIV-positive persons with alcohol problems. Although the effect was attenuated over time, future studies might test the added effectiveness of booster sessions or ongoing adherence counseling.
Parsons
Jeffrey T
JT
Center for HIV/AIDS Educational Studies and Training, New York, NY, USA. jeffrey.parsons@hunter.cuny.edu
Golub
Sarit A
SA
Rosof
Elana
E
Holder
Catherine
C
D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D000437:Alcoholism / Q000150:complications* / Q000523:psychology*; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003071:Cognition; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance; D010353:Patient Education as Topic; D016896:Treatment Outcome; D019562:Viral Load
D019380:Anti-HIV Agents