Incentives to Promote Medication Adherence Among HIV-Infected Youth

PRIMARY OBJECTIVE: * To describe the effects of a novel incentive intervention model on HIV-infected youths' patterns of antiretroviral medication adherence. SECONDARY OBJECTIVES: * To evaluate the feasibility of an outpatient incentive intervention model. * To assess participant satisfaction with the incentive intervention model. * To evaluate the effect of an outpatient incentive intervention model on targeted health behaviors (numbers of missed appointments and STI diagnoses). * To measure the effect of the incentive intervention on HIV viral load and CD4+ count. * To determine the overall and per patient cost of the incentive intervention model. * To describe associations between adherence measures: real-time medication monitor data, pharmacy pill count, pharmacy prescription pick-up data, medication possession ratio, and self-report. Upon enrollment, participants will receive education and a real-time medication monitor. Participants will be followed monthly in the clinic and will be prescribed thirty-day supplies of medication. During weeks 1-4 participants will establish a baseline with the real-time medication monitor. During weeks 5-28, participants will receive remote incentives based on their level of medication adherence as measured by the real-time medication monitor. Additional lottery-style incentives will occur at regular follow-up visits. No incentives will be applied during weeks 29-48. Participants will complete the protocol at the week 48 visit.