Testing Two Interventions to Improve Health Outcomes and Quality of Life Among Rural Older Adults Living With HIV
- Conditions
- HIV
- Interventions
- Behavioral: Supportive-Expressive Peer Social Support Group InterventionBehavioral: Individual Strengths-Based Case Management Intervention
- Registration Number
- NCT06269081
- Lead Sponsor
- Medical College of Wisconsin
- Brief Summary
Engagement in HIV medical care and adherence to HIV medications are both essential in improving health outcomes among people living with HIV (PLH), but PLH living in rural areas-who suffer higher mortality rates than their urban counterparts-can confront multiple barriers to care engagement and adherence, especially as they face the logistical, medical, and social challenges associated with aging. This project will test the efficacy of two interventions to determine their impact on HIV health outcomes and quality of life among rural, older PLH living in the Southern U.S. The two interventions, adapted from evidence-based interventions and delivered remotely, are: (1) supportive-expressive peer social support groups and (2) strengths-based case management. We hypothesize that both interventions will increase viral suppression, antiretroviral therapy adherence, and health-related quality of life and decrease depressive symptoms. Results from this study will provide us with tools to improve health outcomes for rural older people living with HIV.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 352
- Aged 50 years or greater
- Living in a county with a score of .4 or higher on the index of relative rurality (IRR)
- Living in Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, or West Virginia
- Living with HIV
- Has a telephone at home
- Able to provide informed consent
- Not meeting eligibility criteria described above
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description Supportive-Expressive Peer Social Support Group + Individual Strengths-Based Case Management Supportive-Expressive Peer Social Support Group Intervention - Supportive-Expressive Peer Social Support Group + Individual Strengths-Based Case Management Individual Strengths-Based Case Management Intervention - Supportive-Expressive Peer Social Support Group Supportive-Expressive Peer Social Support Group Intervention - Individual Strengths-Based Case Management Individual Strengths-Based Case Management Intervention -
- Primary Outcome Measures
Name Time Method Depressive Symptoms 4, 8, and 12 month follow-ups Depressive symptoms during the past 2 weeks will be self-reported via completion of the 9-item Patient Health Questionnaire-9 (PHQ-9). The calculated scale range is 0-27, with higher scores indicating more depressive symptoms.
Antiretroviral Treatment Medication Adherence 4, 8, and 12 month follow-ups Recent (past 30 day) antiretroviral treatment adherence will be self-reported using the 3-item Wilson Medication Adherence Scale. The calculated scale range is 0-100, with higher scores indicating more consistent medication adherence.
Viral Suppression 4 and 12 month follow-ups HIV viral load will be assessed using self-collected dried blood spot (DBS) samples, with samples collecting using HemaSpot devices. Viral suppression will be defined as a measured viral load less than or equal to 839 copies/mL.
Health-Related Quality of Life 4, 8, and 12 month follow-ups Health-related quality of life will be self-reported using the 31-item World Health Organization Quality of Life Brief Assessment for PLH (WHOQOL-HIV BREF). The calculated scale range is 0-100, with higher scores indicating better quality of life. Composite scores will be calculated in line with Walsh et al., 2024.
- Secondary Outcome Measures
Name Time Method Accessing Needed Social and Medical Services 4, 8, and 12 month follow-ups Participants will self-report which of 12 HIV-related social and medical services they have needed during the previous 3 months, and which of these needed services they were able to obtain. A composite variable will indicate whether participants successfully accessed at least one needed service (0 = no, 1 = yes).
Structural Barriers 4, 8, and 12 month follow-ups Participants will self-report structural barriers they have faced in the past 3 months, with items assessing the following barriers: not having current health insurance, transportation as a barrier to health care, finances as a barrier to health care, not having enough food to eat, not having stable housing, and lacking eHealth literacy. Participants will be coded as having faced or not having faced each barrier, and barriers will be summed to indicate a score from 0-6, with higher scores indicating more structural barriers.
HIV Treatment Adherence Self-Efficacy 4, 8, and 12 month follow-ups HIV treatment adherence self-efficacy will be self-reported using the 8-item HIV Treatment Adherence Self-Efficacy Scale (HIV-ASES). Scale scores range from 0-4, with higher scores indicating greater self-efficacy.
Loneliness 4, 8, and 12 month follow-ups Loneliness will be self-reported using the 5-item Loneliness survey from the National Institutes of Health (NIH) Toolbox. Scale scores range from 1-5, with higher scores indicating greater loneliness.
Internalized HIV Stigma 4, 8, and 12 month follow-ups Internalized HIV stigma will be self-reported using the 6-item internalized stigma subscale of the HIV Stigma Mechanisms scale. Scale scores range from 1-5, with higher scores indicating more internalized stigma.
General Self-Efficacy 4, 8, and 12 month follow-ups General self-efficacy will be self-reported using the 8-item New General Self-Efficacy Scale. Scale scores range from 1-5, with higher scores indicating greater self-efficacy.
Social Support 4, 8, and 12 month follow-ups Social support will be self-reported using the 19-item Medical Outcomes Study (MOS) Social Support Scale. Scale scores range from 1-5, with higher scores indicating more social support.
Trial Locations
- Locations (1)
Center for AIDS Intervention Research, Medical College of Wisconsin
🇺🇸Milwaukee, Wisconsin, United States