Highly active antiretroviral therapy (HAART) has produced substantial improvements in health outcomes for HIV patients in a number of clinical trials. However, many HIV patients do not adhere sufficiently to this treatment, and thereby greatly limit its effectiveness. Efforts to increase patients' adherence to HAART have generally produced limited effects, and have not been adequately packaged for dissemination and commercial sale. The purpose of the proposed study is to further develop and evaluate an individualized assessment-based intervention for increasing adherence to HAART, as an important step toward producing a commercially viable HAART adherence enhancement product that can be successfully implemented in a wide range of HIV clinical settings. Ninety HIV patients with identified poor adherence to HAART will be randomly assigned to either 1) standard care, or 2) standard care plus the adherence intervention. At baseline and at 4, 12, and 20-week follow-ups, all subjects will be assessed for 1) adherence to HAART (self-report, pill counts, and pharmacy refills), 2) status on a number of adherence-related psychosocial variables (i.e. social support, depression, treat/health beliefs, adherence self-efficacy, and substance abuse), and 3) viral load and CD4 cell count. Patient and clinician satisfaction, and patient follow-through with the intervention will also be assessed.
