The efficacy of Structural Ecosystems Therapy for HIV medication adherence with African American women.

A systemic family therapy intervention, Structural Ecosystems Therapy (SET; Mitrani, Szapocznik, & Robinson-Batista, 2000; Szapocznik et al., 2004), has been shown to promote adaptation to living with HIV by reducing psychological distress and family hassles. This investigation examines the effect of SET on HIV medication adherence relative to a person-centered condition and a community control condition. Medication adherence was assessed on 156 trial participants. Results of a 2-part model showed that SET was significantly more likely to move women to high levels of adherence (defined as at least 95% adherence) than a person-centered therapy. Family hassles were also significantly reduced by SET, though the effect of SET on medication adherence did not appear related to this change in family hassles.