The development and feasibility of an intervention to improve HAART adherence among HIV-positive patients receiving primary care in methadone clinics

We developed an adherence counseling program to help HIV-positive, opioid dependent patients, receiving primary care in methadone clinics, to improve adherence to highly active antiretroviral therapy (HAART). The intervention is conducted by paraprofessional adherence counselors and consists of six, semi-structured counseling sessions that focus on motivational interviewing and cognitive-behavioral skills training. To date, we have enrolled 119 patients into adherence counseling, suggesting that patients are interested and receptive to the program. Clinic staff has welcomed the additional support provided by the program, and are working collaboratively with the adherence counselors to provide integrated and comprehensive care. The successful implementation of the adherence counseling program indicates that paraprofessionals can effectively be trained to provide semi-structured adherence counseling and that adherence interventions can be incorporated into existing substance abuse and HIV-related treatment programs.