An Adherence Intervention That Works — but with a Catch

Most studies of adherence interventions have suggested either transient or no significant benefit. In a recent randomized, investigator-blind trial conducted at three outpatient clinics in Philadelphia, researchers compared an intensive adherence intervention with usual care.

The study involved 180 adults (60% men, 85% black) with HIV RNA ≥1000 copies/mL who were initiating antiretroviral therapy (ART) or changing their regimens. Participants were randomized to receive usual care or an adherence intervention called Managed Problem Solving (MAPS). The latter involved four in-person sessions (the first lasting 60 to 90 minutes; the others, 20 to 45 minutes) with an “interventionist” who had undergone 15 hours of study-specific training. Sessio…