Peer Reviewed


For HIV, Behavioral Counseling Improves Medication Adherence, Reduces Alcohol Use

Telephone and clinic-based behavioral health counseling may improve medication adherence and reduce alcohol use among individuals with HIV, according to a recent randomized community trial. 

To compare the efficacy of the counseling methods, the researchers included 240 adults with HIV living in a rural setting. Participants were randomly assigned to receive telephone behavioral health counseling, clinic-based behavioral health counseling, or the control condition—attention control nutrition education—for 12 months. All behavioral health counseling was completed by either a community nurse or a paraprofessional patient navigator.

The primary outcomes of the study included medication adherence measured by unannounced pill counts and alcohol use measured by electronic daily text message assessments. The researchers also measured HIV viral load and retention in care using data from patient medical records at 18 months.

The results indicated that medication adherence increased in the short term for individuals who received telephone and office-based counseling, compared with the control condition. Further, a more significant decrease in alcohol use was observed following clinic-based behavioral counseling, compared with both telephone counseling and the control condition. No other differences were observed between the conditions, and no differences were observed during counseling between a community nurse or the patient navigator.

“Telephone and clinic-based counseling demonstrated improved medication adherence in the short term, while clinic-based counseling demonstrated reductions in alcohol use,” the researchers concluded. “The modest outcomes suggest that intensive intervention strategies are needed for patients that clinicians identify as at-risk for treatment discontinuation and treatment failure.”


—Leigh Precopio



Kalichman SC, Katner H, Eaton LA, Hill M, Ewing W, Kalichmnan MO. Randomized community trial comparing telephone versus clinic-based behavioral health counseling for people living with HIV in a rural setting. J Rural Health. Published online September 8, 2021.