title: Effects of a behavioral intervention on antiretroviral medication adherence among people living with HIV: the healthy living project randomized controlled study.
abstract: OBJECTIVE
  To examine the effect of a 15-session individually delivered cognitive behavioral intervention on antiretroviral (ART) medication adherence.
  
  
  METHODS
  A multisite, 2-group, randomized controlled trial.
  
  
  METHODS
  Two hundred four HIV-infected participants with self-reported ART adherence <85% from a total of 3818 participants screened were randomized into the trial. Potential participants were recruited for the main trial based on sexual risk criteria in Los Angeles, Milwaukee, New York, and San Francisco.
  
  
  METHODS
  The primary outcome of the intervention was a reduction in HIV transmission risk behaviors. Fifteen 90-minute individually delivered sessions were divided into 3 modules: Stress, Coping, and Adjustment; Safer Behaviors; and Health Behaviors, including an emphasis on ART adherence. Controls received no intervention until trial completion. Both groups completed follow-up assessments at 5, 10, 15, 20, and 25 months after randomization.
  
  
  METHODS
  Self-reported ART adherence as measured by 3-day computerized assessment.
  
  
  RESULTS
  A significance difference in rates of reported adherence was observed between intervention and control participants at months 5 and 15, corresponding to the assessments after the Stress, Coping, and Adjustment module (5-month time point) and after the Health Behaviors module (15-month time point). The relative improvements among the intervention group compared with the control group dissipated at follow-up.
  
  
  CONCLUSIONS
  Cognitive behavioral intervention programs may effectively improve ART adherence, but the effects of intervention may be short-lived.
authors.affiliation: Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA 95105, USA. mallory.johnson@ucsf.edu
authors.forename: Mallory O
authors.initials: MO
authors.lastname: Johnson
authors.forename: Edwin
authors.initials: E
authors.lastname: Charlebois
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Morin
authors.forename: Robert H
authors.initials: RH
authors.lastname: Remien
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Chesney
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001521:Behavior Therapy / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012309:Risk-Taking; D012650:Self Disclosure; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents