The Office of National AIDS Policy (2000) estimates that half of new HIV infections occur in youth under the age of 25. Sexual risk behaviors and substance use appear to be highly prevalent among HIV positive youth. The few studies of HIV positive youth suggest adherence rates that are dismally inadequate to manage the disease. Adherence is a multi-dimensional construct that includes taking medication, keeping appointments, and general health behaviors. Poor adherence increases transmission risk resulting from elevated viral loads. This triad of risk behaviors in HIV-infected youth (drug use, sexual behaviors, and health behaviors) must be targeted in intervention studies. We plan to pilot an empirically validated risk reduction intervention, Motivational Enhancement Therapy (MET), that can be easily disseminated and integrated into existing HIV clinics and community-based organizations addressing the needs of HIV positive youth. The proposed study is a randomized clinical trial with a wait-list control examining the utility of MET. This pilot study will use a sample of 60, ages 16-24, 30 of whom will receive MET immediately after baseline and 30 of whom will begin MET after the 9-month post-test. A repeated measures design will be used for the proposed study with a multiple baseline for the control group to examine level and trend effects. Youth will complete an initial data collection sessions (baseline), and then 30 youth will be assigned to the treatment condition. These youth will complete a three month post-test designed to coincide with treatment completion. Subsequent post-tests occur at nine months and 15 months after baseline data collection (6 and 12 months after treatment completion). At that point, the wait-list group will begin treatment. The waitlist control will receive standard care during the initial treatment period. For those in care, all four sites offer comprehensive, multidisciplinary care including social work and case management services. Those youth in the control condition who are not in care will be given referral for medical care. Youth in the control condition w ill participate in the three month and nine month post-test for the multiple baseline design. They will than enter treatment and receive additional post-tests at 12 months (post-treatment), 18 months (6months after treatment completion) and 24 (12 months after treatment completion). If successful, this intervention will provide immediate assistance to vulnerable population to prevent the spread of HIV and to minimize its negative physical and psychological effects.