Increasing Social Support to Improve HIV Care Engagement and Adherence in St. Petersburg, Russia
| Status: | Active, not recruiting |
|---|---|
| Conditions: | HIV / AIDS |
| Therapuetic Areas: | Immunology / Infectious Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 1/26/2019 |
| Start Date: | June 2014 |
| End Date: | July 2019 |
Increasing Social Support to Improve HIV Care Engagement and Adherence
Prior research has documented serious health, mental health, and social-behavioral issues
among people living with HIV (PLH) in St. Petersburg. The investigators have established that
PLH are clustered in friendship groups with other HIV+ persons and that an intervention
delivered to groups composed of HIV+ men who have sex with men (MSM) who were friends in real
life reduced mental health distress more than individual counseling. Specific aims of the
collaborative mixed-methods, qualitative/ quantitative research are to: (1) identify
facilitators and barriers of medical care attendance and ART adherence among PLH in St.
Petersburg; (2) integrate these data into an intervention designed to increase HIV care
attendance, retention, and adherence; (3) carry out a test-of-concept pilot study that
recruits groups of PLH friends and delivers an intervention to intact PLH friendship groups
to encourage mutual social support for attending medical appointments and adhering to HIV
care; and (4) evaluate the effects of the intervention on both behavioral and biological
measures, including viral load. These specific aims will be achieved by research carried out
in two phases:
In Phase I, we will conduct in-depth interviews with 60 PLH and key informants in St.
Petersburg purposively selected to include HIV+ persons in and not in medical care, adherent
or not adherent to ART, and including men and women representing diverse exposure risks.
In-depth interviews will be analyzed to identify factors associated with attending or not
attending care and adhering or not adhering to ART, as well as identifying how HIV+ friends
can support one another in HIV care entry, retention, and adherence.
In Phase II, the investigators will undertake a randomized intervention pilot study in which
20 groups of PLH friends are recruited by enrolling a PLH seed who is not reliably in care or
is ART nonadherent and then recruiting all friends known by the seed to also be HIV+. A
7-session group intervention will be undertaken with all members of the friendship groups in
the experimental condition to increase care and adherence-related social support,
problem-solving, and mutual assistance for care. Baseline to 6-month followup data will
determine whether the intervention produces greater improvement than found in the comparison
group in care attendance and treatment adherence, improved mental health, lower substance
use, and lower HIV viral load.
among people living with HIV (PLH) in St. Petersburg. The investigators have established that
PLH are clustered in friendship groups with other HIV+ persons and that an intervention
delivered to groups composed of HIV+ men who have sex with men (MSM) who were friends in real
life reduced mental health distress more than individual counseling. Specific aims of the
collaborative mixed-methods, qualitative/ quantitative research are to: (1) identify
facilitators and barriers of medical care attendance and ART adherence among PLH in St.
Petersburg; (2) integrate these data into an intervention designed to increase HIV care
attendance, retention, and adherence; (3) carry out a test-of-concept pilot study that
recruits groups of PLH friends and delivers an intervention to intact PLH friendship groups
to encourage mutual social support for attending medical appointments and adhering to HIV
care; and (4) evaluate the effects of the intervention on both behavioral and biological
measures, including viral load. These specific aims will be achieved by research carried out
in two phases:
In Phase I, we will conduct in-depth interviews with 60 PLH and key informants in St.
Petersburg purposively selected to include HIV+ persons in and not in medical care, adherent
or not adherent to ART, and including men and women representing diverse exposure risks.
In-depth interviews will be analyzed to identify factors associated with attending or not
attending care and adhering or not adhering to ART, as well as identifying how HIV+ friends
can support one another in HIV care entry, retention, and adherence.
In Phase II, the investigators will undertake a randomized intervention pilot study in which
20 groups of PLH friends are recruited by enrolling a PLH seed who is not reliably in care or
is ART nonadherent and then recruiting all friends known by the seed to also be HIV+. A
7-session group intervention will be undertaken with all members of the friendship groups in
the experimental condition to increase care and adherence-related social support,
problem-solving, and mutual assistance for care. Baseline to 6-month followup data will
determine whether the intervention produces greater improvement than found in the comparison
group in care attendance and treatment adherence, improved mental health, lower substance
use, and lower HIV viral load.
Inclusion Criteria:
- Age 18 or older
- Self-report as being HIV-positive
- Except for initial seeds, must be named by an already-enrolled participant as an
HIV-positive friend
- Do not plan to move from the St. Petersburg area for the next 12 months
- Able to provide written informed consent and do not exhibit severe alcohol
intoxication, drug use impairment, or acute psychiatric impairment.
Exclusion Criteria:
- Age 17 or younger
- Self-report as HIV-negative
- Not named as an HIV-positive friend by an already-enrolled participant
- Plans to move from the St. Petersburg area in the next 12 months
- Exhibit severe alcohol intoxication, drug use impairment, or acute psychiatric
impairment
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