title: Integrated behavioral intervention to improve HIV/AIDS treatment adherence and reduce HIV transmission.
abstract: OBJECTIVE
  We conducted a randomized clinical trial to test an integrated behavioral intervention designed to enhance using HIV treatment as prevention by improving medication adherence, reducing risks for other sexually transmitted infections, and minimizing risk compensation beliefs.
  
  
  METHODS
  Individuals living with HIV/AIDS (n = 436) participated in a randomized clinical trial testing an intensive behavioral intervention aimed at reducing HIV transmission risks compared with an attention control condition. We used unannounced pill counts to monitor antiretroviral therapy adherence and computerized interviews to measure risk behaviors.
  
  
  RESULTS
  The integrated transmission risk reduction intervention demonstrated increased antiretroviral therapy adherence and less unprotected intercourse with nonseroconcordant partners at 3- and 6-month follow-ups as well as fewer new sexually transmitted infections diagnosed over the 9-month follow-up period (adjusted odds ratio = 3.0; P < .05; 95% confidence interval = 1.01, 9.04). The integrated intervention also reduced behavioral risk compensation beliefs.
  
  
  CONCLUSIONS
  A theory-based integrated behavioral intervention can improve HIV treatment adherence and reduce HIV transmission risks. HIV treatment as prevention should be bundled with behavioral interventions to maximize effectiveness.
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, CT 06269, USA. seth.k@uconn.edu
authors.forename: Seth C
authors.initials: SC
authors.lastname: Kalichman
authors.forename: Chauncey
authors.initials: C
authors.lastname: Cherry
authors.forename: Moira O
authors.initials: MO
authors.lastname: Kalichman
authors.forename: Christina M
authors.initials: CM
authors.lastname: Amaral
authors.forename: Denise
authors.initials: D
authors.lastname: White
authors.forename: Howard
authors.initials: H
authors.lastname: Pope
authors.forename: Connie
authors.initials: C
authors.lastname: Swetzes
authors.forename: Lisa
authors.initials: L
authors.lastname: Eaton
authors.forename: Rene
authors.initials: R
authors.lastname: Macy
authors.forename: Demetria
authors.initials: D
authors.lastname: Cain
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D001521:Behavior Therapy / Q000379:methods*; D005260:Female; D005845:Georgia / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D008297:Male; D010349:Patient Compliance; D016012:Poisson Distribution; D040242:Risk Reduction Behavior; D015229:Sexually Transmitted Diseases, Viral / Q000188:drug therapy* / Q000517:prevention & control* / Q000635:transmission; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents