Service Delivery

HAART adherence strategies for methadone clients who are HIV-positive: a treatment manual for implementing contingency management and medication coaching.

Haug et al. (2006) · Behavior modification 2006
★ The Verdict

Use voucher incentives and a fish-bowl lottery alongside medication coaching to boost HAART adherence in HIV-positive methadone clients.

✓ Read this if BCBAs in community clinics serving HIV-positive adults on methadone.
✗ Skip if Clinicians who only treat children or who already run a proven adherence program.

01Research in Context

01

What this study did

Eisenhower et al. (2006) wrote a step-by-step manual for clinicians.

It shows how to mix two things: voucher prizes, a fish-bowl lottery, and weekly coaching talks.

The goal is to help HIV-positive adults on methadone take every HAART pill on time.

02

What they found

The paper gives no patient data.

It only hands you the script, forms, and prize rules ready to print.

03

How this fits with other research

Gabriels et al. (2001) and Carter et al. (2011) also give plug-and-play manuals.

All three skip outcome numbers and serve the therapist, not the journal.

Dunham (1972) is different: one man in a state hospital cried less when smiles earned tokens and tears cost tokens.

That old case shows token economies can change behavior; A et al. give you the modern toolkit to try it for pill taking.

04

Why it matters

If you run a clinic for clients who use methadone and live with HIV, you can open this manual today.

You get a fish-bowl lottery that costs pennies, voucher sheets, and a coach script.

No need to design from scratch; just copy, paste, and start reinforcing adherence next week.

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→ Action — try this Monday

Print the voucher tracking sheet, set up a fish-bowl with 500 prize slips, and award one draw for each observed pill swallow.

02At a glance

Intervention
token economy
Design
methodology paper
Population
substance use disorder
Finding
not reported

03Original abstract

Research demonstrates that injection drug users with HIV and/or AIDS have difficulty adhering to complex regimens of HIV medications. Because of the risk of increased viral resistance associated with irregular medication adherence, there is considerable clinical need to assist clients who abuse substances in taking their antiretroviral medications on time and as directed. This article outlines intervention strategies to improve medication adherence among clients who are in methadone maintenance. In this treatment manual, the authors delineate contingency management procedures, including voucher incentives and a fishbowl lottery prize system. They also describe intervention elements and adherence tools for medication coaching. The purpose of this manual is to describe the intervention procedures for clinicians and to serve as a resource for drug abuse treatment programs that serve clients who are HIV-positive.

Behavior modification, 2006 · doi:10.1177/0145445506288229