Testing a Self-management Intervention in HIV+ Asian Pacific Americans

HIV infection rates are on a rapid rise within Asian Pacific Americans (APA) communities, 17% annually, with men comprising 80% of new infections in the United States. Optimal self-management is a key to HIV treatment success, because it may alleviate physical and mental symptoms, promote health behaviors, and therefore enhance quality of life and suppress virus replication. Studies suggested that securing assistance from family members in self-management may be effective in addressing these challenges in APA communities.

The purpose of this study is to adapt and evaluate the feasibility of a 4-session, 4-week family-informed self-management intervention protocol to promote health among APA living with HIV (APAWH). The scientific premise is, regardless of Asian ethnicity, APA communities often share a more collectivist orientation, such that APA prioritizing their responsibilities to their families over their own individual needs. To preserve the harmony in family, HIV disclosure is often indirect. In previous projects, investigators interviewed an ethnically diverse sample of 40 APAWH and 20 family members to explore self- and family- management strategies. The hypothesis is that APAWH will receive greater levels of family support and health following the family-informed self-management intervention. This study addresses the critical need to optimize self-management skills among APAWH that simultaneously address the needs of APAWH with support from their families. The long-term goal is to implement a comprehensive, family-informed self-management intervention for APAWH.

In this project, researchers will conduct a mixed-methods study with two study phases. In Phase 1, researchers will analyze the available qualitative data from the prior projects to revise the conceptualization of family-informed self-management. Based on the revised conceptualization, researchers will adapt an evidence-based self-management intervention (Social justice Oriented, Family Informed, also known as SOFI) using a modified ADAPT-ITT model. In Phase 2, researchers will conduct an implementation study to test the appropriateness, acceptability, feasibility, and preliminary efficacy of the Social justice Oriented, Family Informed self-management intervention among APAWH (SOFIAA) without explicitly involving their family members. Researchers will use study findings to revise this family-informed self-management intervention protocol for a future fully powered randomized controlled trial to test its efficacy. Aims are to: 1. Follow the ADAPT-ITT model to culturally adapt an evidence-based family-informed self-management intervention 2. Evaluate the feasibility, acceptability, appropriateness and preliminary efficacy of the SOFIAA. And, 3. Finalize the study protocols for future project operations by documenting emerging difficulties and solutions throughout this project's implementation.