Because successful HIV treatment requires exceptional adherence to antiretroviral therapy (ART), interventions to improve ART adherence are essential. We developed and pilot-tested an intervention to improve ART adherence, based on brief motivational interviewing (MI), which has successfully improved selected health behaviors but has not been tested for ART adherence. We administered the 15- to 30-minute MI session to 20 HIV-positive adults and assessed its usefulness and relevance. Then, we content-analyzed the session for HIV care issues and strategies most salient to patients in the MI session. During the session, all participants chose an HIV-care-related topic that they wanted to discuss, and talked about issues, barriers, and facilitators related to their topic. Most participants (70%) developed strategies to help improve their health. Questions asked after the MI session revealed that almost all (95%-100%) participants found the session useful and helpful. This theoretically based, empowering health counseling approach for HIV-positive persons warrants further research.