Multi-Component Intervention to Improve Health Outcomes and Quality of Life Among Rural Older Adults Living With HIV

Medical College of Wisconsin

Status: Completed

Conditions: HIV

Treatments: Behavioral: Strengths-Based Case Management (SBCM); Behavioral: Personalized Technology Detailing; Behavioral: HIV Stigma Reduction; Behavioral: Group-Based Social Support

Study type: Interventional

Funder types: Other

Identifiers

NCT04549259

R56NR019443

Details and patient eligibility

About

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 pilot test four intervention components designed to improve care engagement and medication adherence to determine their impact on health outcomes and quality of life among rural, older PLH. The four intervention components, adapted from evidence-based interventions and delivered remotely, are: (1) counselor-facilitated peer social support, (2) HIV stigma reduction, (3) strengths-based case management, and (4) individually-tailored technology use optimization. The investigators hypothesize that components will be acceptable to participants, will be feasible to administer remotely, and will show preliminary impact on (1) the proportion of participants that have viral suppression and (2) health-related quality of life. Results from this study will provide us with tools to improve health outcomes for rural older people living with HIV.

Enrollment: 61 patients

Sex: All

Ages: 50+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 50 years or greater
• Living in a zip code classified as a "Small and Isolated Small Rural Town" area by Rural-Urban Commuting Area Codes (RUCAs), and/or in a county classified as rural based on RUCAs, and/or in a county with a score of .4 or higher on the index of relative rurality (IRR)
• Living in Alabama, Arkansas, Georgia, Kentucky, Mississippi, Missouri, Oklahoma, South Carolina, or Tennessee
• Living with HIV
• Indicates willingness to participate in support groups
• Indicates willingness to self-collect a dried blood spot sample
• Has a telephone at home
• Able to provide informed consent

Exclusion criteria

• Not meeting eligibility criteria described above

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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61 participants in 16 patient groups

Social Support + Stigma Reduction + SBCM + Tech Detailing

Experimental group

Treatment:

Behavioral: Group-Based Social Support

Behavioral: Personalized Technology Detailing

Behavioral: HIV Stigma Reduction

Behavioral: Strengths-Based Case Management (SBCM)

Social Support + Stigma Reduction + SBCM

Experimental group

Treatment:

Behavioral: Group-Based Social Support

Behavioral: HIV Stigma Reduction

Behavioral: Strengths-Based Case Management (SBCM)

Social Support + Stigma Reduction + Technology Detailing

Experimental group

Treatment:

Behavioral: Group-Based Social Support

Behavioral: Personalized Technology Detailing

Behavioral: HIV Stigma Reduction

Social Support + Stigma Reduction

Experimental group

Treatment:

Behavioral: Group-Based Social Support

Behavioral: HIV Stigma Reduction

Social Support + SBCM + Technology Detailing

Experimental group

Treatment:

Behavioral: Group-Based Social Support

Behavioral: Personalized Technology Detailing

Behavioral: Strengths-Based Case Management (SBCM)

Social Support + SBCM

Experimental group

Treatment:

Behavioral: Group-Based Social Support

Behavioral: Strengths-Based Case Management (SBCM)

Social Support + Technology Detailing

Experimental group

Treatment:

Behavioral: Group-Based Social Support

Behavioral: Personalized Technology Detailing

Social Support

Experimental group

Treatment:

Behavioral: Group-Based Social Support

Stigma Reduction + SBCM + Technology Detailing

Experimental group

Treatment:

Behavioral: Personalized Technology Detailing

Behavioral: HIV Stigma Reduction

Behavioral: Strengths-Based Case Management (SBCM)

Stigma Reduction + SBCM

Experimental group

Treatment:

Behavioral: HIV Stigma Reduction

Behavioral: Strengths-Based Case Management (SBCM)

Stigma Reduction + Technology Detailing

Experimental group

Treatment:

Behavioral: Personalized Technology Detailing

Behavioral: HIV Stigma Reduction

Stigma Reduction

Experimental group

Treatment:

Behavioral: HIV Stigma Reduction

SBCM + Technology Detailing

Experimental group

Treatment:

Behavioral: Personalized Technology Detailing

Behavioral: Strengths-Based Case Management (SBCM)

SBCM

Experimental group

Treatment:

Behavioral: Strengths-Based Case Management (SBCM)

Technology Detailing

Experimental group

Treatment:

Behavioral: Personalized Technology Detailing

HIV Information Only

No Intervention group

Description:

This arm will not receive any of the 4 intervention components but will receive information on successfully aging with HIV.