The goal of this proposed study is to conduct a randomized trial of an intervention designed to raise levels of HIV antiretroviral treatment adherence and thereby lower HIV viral load levels among HIV seropositive alcohol abusers. We will conduct a randomized trial of the adherence intervention (N=617). The intervention, derived from social action theory will consist of a series of six individual sessions. We will test the efficacy of the intervention by comparing the regular treatment and intervention arms by prevalence (and level of) detectable HIV viral loads in blood, level of CD4 counts in blood and higher rates of self- reported adherence to antiviral treatment regimens. Evaluation of the participants will occur at three month intervals for a year, for a total of five waves of data collection. Specifically, the hypotheses to be tested are that the intervention group will have a lower prevalence of detectable HIV viral loads, higher CD4 counts and higher rates of self- reported adherence to antiviral treatment regimens at Waves 2-5. We will be able to determine not only whether self-reported levels of adherence to HIV treatments are raised among those who participate in the intervention but we will also be able to measure whether levels of plasma HIV viral load are lowered in the intervention group. By using both self-report behavioral data (confirmed through MEMS Caps data) and biomedical outcome measures, we will be able to determine whether the proposed intervention results in both behaviorally-desirable and medically-meaningful outcomes.
