Two strategies to increase adherence to HIV antiretroviral medication: Life-steps and medication monitoring

Advances in the medical treatment of HIV have made it clear that adherence to highly active antiretroviral treatment is a crucial feature for treatmen t success. The present paper had two goals: (1) to examine psychosocial pre dictors of adherence in persons receiving HIV antiretroviral therapy; (2) t o compared two minimal-treatment interventions to increase HIV medication a dherence in a subset of persons who self-reported less than perfect adheren ce. One of the interventions, Life-Steps, is a single-session intervention utilizing cognitive-behavioral, motivational interviewing, and problem-solv ing techniques. The other intervention, self-monitoring, utilizes a pill-di ary and an adherence questionnaire alone. Significant correlates of adheren ce included depression, social support, adherence self-efficacy, and punish ment beliefs about HIV. Depression was a significant unique predictor of ad herence over and above the other variables. Both interventions yielded impr ovement in adherence from baseline, and the Life-Steps intervention showed faster improvements in adherence for persons with extant adherence problems . (C) 2001 Elsevier Science Ltd. All rights reserved.