Adaptation of an HIV Medication Adherence Intervention for Adolescents and Young Adults

• HIV medication adherence intervention for lesbian, gay, bisexual and heterosexual 13- to 24-year-olds
• Five sessions address adherence barriers using problem solving, short message service (SMS), and video vignettes
• Intervention implementation with perinatally and behaviorally infected youth shown
• Monitored adherence improved for both cases during the intervention
• Adherence gains were not sustained for the perinatally infected young adult

Rising rates of human immunodeficiency virus (HIV) infection among adolescents and young adults underscore the importance of interventions for this population. While the morbidity and mortality of HIV has greatly decreased over the years, maintaining high rates of adherence is necessary to receive optimal medication effects. Few studies have developed interventions for adolescents and young adults and none have specifically been developed for sexual minority (lesbian, gay, and bisexual; LGB) youth. Guided by an evidence-based adult intervention and adolescent qualitative interviews, we developed a multicomponent, technology-enhanced, customizable adherence intervention for adolescents and young adults for use in a clinical setting. The two cases presented in this paper illustrate the use of the five-session positive strategies to enhance problem solving (Positive STEPS) intervention, based on cognitive-behavioral techniques and motivational interviewing. We present a perinatally infected heterosexual woman and a behaviorally infected gay man to demonstrate the unique challenges faced by these youth and showcase how the intervention can be customized. Future directions include varying the number of intervention sessions based on mode of HIV infection and incorporating booster sessions.