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Abstract
High levels of medication adherence are crucial to the success of HIV treatment. Consequently, substance abuse counselors (SACs), social service and other care providers can best support their HIV positive clients when they understand adherence and related interventions. This paper describes a training program that was designed to increase counselor knowledge of HIV medications, adherence strategies and enhance counseling skills specific to HIV adherence. For substance abuse counselors the training needs included: better understanding of medication interactions, relapse, recovery, and interdisciplinary communication. Thirty-six SACs from three agencies completed the 11/2-day training, which included lecture discussions, case discussion and interactive client case simulations. Success in accomplishing training objectives was evaluated at three points: preintervention training, post-intervention, and six month follow-up to determine changes in participants' knowledge, attitudes and behaviors related to adherence counseling. Three case scenarios measuring counselor comfort levels indicated SACs felt significantly more comfortable discussing relapse and medication issues with their HIV affected clients than they would in discussing medication issues with the client's physician. However, they felt slightly more comfortable about physician discussions after training. Open-ended comments by SACs at six-month follow-up provided insights into recovery issues their clients faced. The findings suggest ways medication adherence could fit the reality of serving clients with co-occurring HIV and substance use to better meet their health and support needs.