Couple-focused support to improve HIV medication adherence: a randomized controlled trial

Area of Science:

• Clinical Medicine
• Public Health
• Behavioral Science

Background:

• Medication adherence is critical for managing HIV/AIDS.
• Adherence challenges are prevalent in HIV-serodiscordant couples, particularly among minority populations.
• Existing interventions often lack a couple-centered approach.

Purpose of the Study:

• To evaluate a couple-based intervention aimed at enhancing medication adherence in HIV-serodiscordant individuals.
• To assess the efficacy of the SMART Couples intervention compared to usual care.

Main Methods:

• Randomized controlled trial (SMART Couples Study) involving 215 HIV-serodiscordant couples with baseline adherence < 80%.
• Intervention group received a four-session couple-focused adherence program; control group received usual care.
• Medication adherence measured using a Medication Event Monitoring System cap at baseline, 8 weeks, 3 months, and 6 months.

Main Results:

• The couple-based intervention significantly improved medication adherence compared to usual care at 8 weeks.
• Intervention participants were more likely to achieve high adherence levels (>80%, >90%, >95%).
• Adherence benefits showed a decrease at 3- and 6-month follow-ups.

Conclusions:

• The SMART Couples program demonstrated significant short-term improvements in medication adherence.
• Long-term adherence remained suboptimal for many participants, indicating a need for sustained support.
• Couple-based strategies show promise but require further refinement for lasting impact.