Large scale clinical trial studies, such as cardiovascular and cancer prevention, have shown that patient dropout and failure to adhere to study protocols can severely complicate interpretation of study results. To date, HIV/AIDS protocol adherence has been given little attention, perhaps because most protocols have been tested in relatively compliant homosexual populations. Unless adherence can be initiated and maintained in all study subpopulations, clinical trials cannot be successfully completed and therapeutic efficacy cannot be interpreted from the results. The goal of the proposed study is to define factors related to HIV protocol adherence in a diverse HIV-infected population which includes large numbers of homosexual male, female, Black, and intravenous drug users. The five specific aims of the proposed study are: (1) to document the extent of nonadherence with different types of protocols; (2) to develop and refine survey instruments to assess psychosocial and medical care factors; 930 to conduct exploratory analysis of the relationships between psychosocial/medical care factors and HIV treatment protocol adherence; (4) to identify psychosocial and medical care factors related to HIV protocol nonadherence; (5) to develop an education or support strategy.
