A Remotely-Delivered CBT and Contingency Management Therapy for Substance Using People with HIV

AIDS Behav. 2015 Jun;19 Suppl 2(0 2):156-62. doi: 10.1007/s10461-014-0990-x.


Substance using HIV patients are at risk for non-adherence, and most prior interventions in this population have had only modest effects on adherence. Contingency management (CM) is a promising intervention. The Centralized Off-site Adherence Enhancement (CARE) program involved 12 telephone-delivered substance and adherence-targeted cognitive behavior therapy sessions coupled with CM for adherence to antiretroviral therapy (ART) and counseling participation. CM involved 6 weeks of escalating reinforcement for taking prescribed doses followed by 6 weeks of tapering variable rate reinforcement, and separate reinforcement for counseling ($806 possible). Participants' adherence was measured by devices which wirelessly provided real-time notification of device-opening. HIV infected patients on ART (N = 10) with recent stimulant or alcohol use completed 10.2 of 12 possible telephone sessions, spent 42.8 min/call, and rated the counseling 6.2 on a 1-7 scale. Medication adherence improved from 81 to 93 % (p = 0.04). CARE appears to be acceptable and engaging.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anti-Retroviral Agents / administration & dosage
  • Anti-Retroviral Agents / therapeutic use*
  • California
  • Cognitive Behavioral Therapy*
  • Directive Counseling / methods*
  • Feasibility Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • Humans
  • Male
  • Medication Adherence*
  • Motivation
  • Patient Acceptance of Health Care
  • Program Evaluation
  • Substance Abuse, Intravenous / complications
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / therapy*
  • Telephone
  • Treatment Outcome
  • Young Adult


  • Anti-Retroviral Agents