Addressing Syndemics and Self-care in Individuals with Uncontrolled HIV: An Open Trial of a Transdiagnostic Treatment

S. A. Safren, A. Harkness, J. S. Lee, B. G. Rogers, N. A. Mendez, J. F. Magidson, A. J. Blashill, S. Bainter, A. Rodriguez, G. Ironson

Research output: Contribution to journalArticlepeer-review

Abstract

Interventions addressing syndemics and ART adherence are needed for individuals with uncontrolled HIV and psychosocial problems. Twenty-seven participants with detectable HIV plasma viral load (PVL) or recent STI participated in an open trial of transdiagnostic adherence counseling and cognitive behavioral therapy. Outcomes were collected at baseline, 4-, and 8-months. Log PVL improved from baseline to 4-month (γ = − 1.13, 95% CI − 1.72, − 0.55, p ' 0.001) and 8-month (γ = − 0.93, 95% CI − 1.57, − 0.30, p = 0.006), with more participants suppressed at 4- (χ2(1) = 9.09, p = 0.001) and 8-month (χ2(1) = 5.14, p = 0.016). Self-reported adherence improved across major assessments (γ = 0.87, 95% CI 0.28, 1.46, p =.005); Wisepill adherence did not. Negative affect declined during treatment (γ = − 0.28, 95% CI − 0.40, − 0.16, p ' 0.001), with improvement at 4- (γ = − 4.34, 95% CI − 6.99, − 1.69, p = 0.002) but not 8-month. Positive affect trended positively during treatment and from baseline to 4-month, with significant 8-month improvement (γ = 3.84, 95% CI 0.33, 7.44, p = 0.04). Depressive symptoms did not change. In a complicated sample of participants selected for uncontrolled HIV, the intervention yielded improved PVL and self-reported adherence. Efforts to end HIV should improve upon strategies such as these, addressing syndemics. Registration: clinicaltrial.gov: NCT02696681.

Original languageEnglish (US)
Pages (from-to)3264-3278
Number of pages15
JournalAIDS and Behavior
Volume24
Issue number11
DOIs
StatePublished - Nov 1 2020

Keywords

  • Adherence
  • Antiretroviral therapy
  • Cognitive behavioral therapy
  • HIV
  • Syndemics

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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