TY - JOUR
T1 - Addressing Syndemics and Self-care in Individuals with Uncontrolled HIV
T2 - An Open Trial of a Transdiagnostic Treatment
AU - Safren, S. A.
AU - Harkness, A.
AU - Lee, J. S.
AU - Rogers, B. G.
AU - Mendez, N. A.
AU - Magidson, J. F.
AU - Blashill, A. J.
AU - Bainter, S.
AU - Rodriguez, A.
AU - Ironson, G.
N1 - Funding Information:
This study was funded by K24MH094214/9K24DA040489. It was also supported by P30MH116867 and 5P30AI073961. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health, the National Institute of Drug Abuse, The National Institute for Allergy and Infectious Disease, or the National Institutes of Health.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - 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.
AB - 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.
KW - Adherence
KW - Antiretroviral therapy
KW - Cognitive behavioral therapy
KW - HIV
KW - Syndemics
UR - http://www.scopus.com/inward/record.url?scp=85085012329&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85085012329&partnerID=8YFLogxK
U2 - 10.1007/s10461-020-02900-7
DO - 10.1007/s10461-020-02900-7
M3 - Article
C2 - 32410049
AN - SCOPUS:85085012329
VL - 24
SP - 3264
EP - 3278
JO - AIDS and Behavior
JF - AIDS and Behavior
SN - 1090-7165
IS - 11
ER -