Couple-focused support to improve HIV medication adherence: a randomized controlled trial
Related Experiment Video
Updated: Aug 18, 2026

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
Published on: March 30, 2014
Robert H Remien1, Michael J Stirratt, Curtis Dolezal
1HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York 10032, USA. rhr1@columbia.edu
Objective:
To assess the efficacy of a couple-based intervention to improve medication-taking behavior in a clinic population with demonstrated adherence problems.
Design:
A randomized controlled trial (SMART Couples Study) conducted between August 2000 and January 2004.
Setting:
Two HIV/AIDS outpatient clinics in New York City.
Participants:
Heterosexual and homosexual HIV-serodiscordant couples (n = 215) in which the HIV-seropositive partner had < 80% adherence at baseline. The sample was predominantly lower-income racial/ethnic minorities.
Intervention:
Participants were randomly assigned to a four-session couple-focused adherence intervention or usual care. The intervention consisted of education about treatment and adherence, identifying adherence barriers, developing communication and problem-solving strategies, optimizing partner support, and building confidence for optimal adherence.
Outcome Measures:
Medication adherence at week 8 (2 weeks after the intervention) compared with baseline, assessed with a Medication Event Monitoring System cap.
Results:
Intervention participants showed higher mean medication adherence at post-intervention when compared with controls whether adherence was defined as proportion of prescribed doses taken (76% versus 60%) or doses taken within specified time parameters (58% versus 35%). Also, participants in the intervention arm were significantly more likely to achieve high levels of adherence (> 80%, > 90%, or > 95%) when compared with controls. However, in most cases, effects diminished with time, as seen at follow-up at 3 and 6 months.
Conclusion:
The SMART Couples program significantly improved medication adherence over usual care, although the level of improved adherence, for many participants, was still suboptimal and the effect was attenuated over time.
Related Concept Videos
Retrovirus Life Cycles
Therapeutic Drug Monitoring: Affecting Factors
Clinical Trials
There are four phases in a clinical trial. A phase one...
Bioavailability Study Design: Healthy Subjects Versus Patients
Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...
Clinical Trials: Overview
