title: A Remotely-Delivered CBT and Contingency Management Therapy for Substance Using People with HIV.
abstract: Substance using HIV patients are at risk for non-adherence, and most prior interventions in this population have had only modest effects on adherence. Contingency management (CM) is a promising intervention. The Centralized Off-site Adherence Enhancement (CARE) program involved 12 telephone-delivered substance and adherence-targeted cognitive behavior therapy sessions coupled with CM for adherence to antiretroviral therapy (ART) and counseling participation. CM involved 6 weeks of escalating reinforcement for taking prescribed doses followed by 6 weeks of tapering variable rate reinforcement, and separate reinforcement for counseling ($806 possible). Participants' adherence was measured by devices which wirelessly provided real-time notification of device-opening. HIV infected patients on ART (N = 10) with recent stimulant or alcohol use completed 10.2 of 12 possible telephone sessions, spent 42.8 min/call, and rated the counseling 6.2 on a 1-7 scale. Medication adherence improved from 81 to 93 % (p = 0.04). CARE appears to be acceptable and engaging.
authors: Department of Psychiatry, Yale University School of Medicine, 495 Congress Ave. - MRU Second Floor, New Haven, CT, 06517, USA, brent.moore@yale.edu.
authors: Brent A
authors: BA
authors: Moore
authors: Marc I
authors: MI
authors: Rosen
authors: Yan
authors: Y
authors: Wang
authors: Jie
authors: J
authors: Shen
authors: Karen
authors: K
authors: Ablondi
authors: Anna
authors: A
authors: Sullivan
authors: Mario
authors: M
authors: Guerrero
authors: Lisa
authors: L
authors: Siqueiros
authors: Eric S
authors: ES
authors: Daar
authors: Honghu
authors: H
authors: Liu
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002140:California; D015928:Cognitive Behavioral Therapy; D037001:Directive Counseling / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence; D009042:Motivation; D010342:Patient Acceptance of Health Care; D015397:Program Evaluation; D015819:Substance Abuse, Intravenous / Q000150:complications; D019966:Substance-Related Disorders / Q000150:complications / Q000628:therapy*; D013689:Telephone; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
references: J Acquir Immune Defic Syndr. 2006 Feb 1;41(2):194-200
references: 16394852
references: J Acquir Immune Defic Syndr. 2006 Mar;41(3):315-22
references: 16540932
references: JAMA. 2006 May 3;295(17):2003-17
references: 16670409
references: AIDS. 2006 Jun 12;20(9):1295-302
references: 16816559
references: J Acquir Immune Defic Syndr. 2006 Sep;43(1):27-34
references: 16878047
references: Clin Infect Dis. 2006 Oct 1;43(7):939-41
references: 16941380
references: Drug Alcohol Depend. 2007 Jan 12;86(2-3):230-8
references: 16930854
references: AIDS Patient Care STDS. 2007 Jan;21(1):30-40
references: 17263651
references: Stat Med. 2007 Feb 28;26(5):991-1007
references: 16755546
references: Drug Alcohol Depend. 2007 Apr 17;88(1):54-63
references: 17056206
references: Curr HIV/AIDS Rep. 2007 May;4(2):65-72
references: 17547827
references: AIDS Care. 2007 Oct;19(9):1134-40
references: 18058397
references: AIDS. 2008 Jan 30;22(3):357-65
references: 18195562
references: Cochrane Database Syst Rev. 2008;(2):CD000011
references: 18425859
references: AIDS. 2008 Jul 11;22(11):1355-63
references: 18580615
references: J Acquir Immune Defic Syndr. 2009 Jan 1;50(1):93-9
references: 19295339
references: Drug Alcohol Depend. 2009 Nov 1;105(1-2):56-62
references: 19615830
references: Alcohol Alcohol. 2010 Mar-Apr;45(2):159-66
references: 20061510
references: AIDS Res Hum Retroviruses. 2010 May;26(5):511-8
references: 20455765
references: AIDS. 2010 Jun 19;24(10):1549-59
references: 20502317
references: Psychiatr Clin North Am. 2010 Sep;33(3):511-25
references: 20599130
references: Clin Infect Dis. 2010 Oct 15;51(8):947-56
references: 20825306
references: J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1:S54-61
references: 21317595
references: J Appl Behav Anal. 2010 Fall;43(3):487-91
references: 21358907
references: J Telemed Telecare. 2011;17(4):177-84
references: 21357672
references: AIDS Behav. 2011 Oct;15(7):1381-96
references: 21468660
references: J Consult Clin Psychol. 2012 Jun;80(3):404-15
references: 22545737
references: JAMA. 2012 Jun 6;307(21):2278-85
references: 22706833
references: AIDS Behav. 2013 Jan;17(1):142-7
references: 22246513
references: J Addict Med. 2013 Mar-Apr;7(2):102-7
references: 23388678
references: Addiction. 2013 May;108(5):900-9
references: 23279560
references: AIDS Behav. 2013 Oct;17(8):2756-64
references: 23644816
references: J Appl Behav Anal. 2013 Dec;46(4):750-64
references: 24114862
references: J Gen Intern Med. 2000 Dec;15(12):841-7
references: 11119180
references: J Acquir Immune Defic Syndr. 2002 Dec 15;31 Suppl 3:S145-8
references: 12562039
references: Addict Behav. 2004 May;29(3):507-23
references: 15050670
references: Br J Addict. 1984 Sep;79(3):283-91
references: 6595022
references: Arch Gen Psychiatry. 1994 Mar;51(3):177-87
references: 8122955
references: J Consult Clin Psychol. 1998 Oct;66(5):832-7
references: 9803702
references: J Infect Dis. 2005 Oct 15;192(8):1398-406
references: 16170757
references: Clin Psychol Rev. 2006 Jan;26(1):17-31
references: 16199119