Behavioral Intervention to Enhance HIV Test/Treat
Condition: HIV/AIDS
MeSH terms: Acquired Immunodeficiency Syndrome; HIV Infections
Study type: Interventional

Summary: 
      Prevention strategies that aim to test and treat people for HIV infection are undermined by
      HIV treatment non-adherence and sexually transmitted co-infections (STI). The proposed study
      will test a theory-based behavioral intervention to reduce HIV infectiousness by
      simultaneously improving HIV treatment adherence and reducing sexually transmitted
      co-infections in people living with HIV-AIDS who use alcohol and other drugs. The
      intervention is delivered in a single office-based counseling session followed by 4 cell
      phone delivered counseling sessions in a model that will be ready for immediate dissemination
      to case management and clinical services for people living with HIV/AIDS in resource
      constrained settings.
    

Detailed description: 
      Prevention strategies that aim to test and treat people for HIV infection are undermined by
      HIV treatment non-adherence and sexually transmitted co-infections (STI). Scalable
      interventions are urgently needed to sustain low infectiousness by improving HIV treatment
      adherence and reducing risks for transmitting HIV. This application proposes to test a
      theory-based behavioral intervention to simultaneously improve HIV treatment adherence and
      reduce HIV transmission risk behaviors in people living with HIV/AIDS who use alcohol and
      other drugs. Grounded in Conflict Theory of Decision Making, the intervention will be
      delivered in a mixed format, with one office-based counseling session followed by four cell
      phone delivered counseling sessions. The intervention will be conducted in Atlanta and
      surrounding impoverished areas. Men (n = 250) and women (n = 250) receiving HIV treatment
      will be recruited from AIDS services and infectious disease clinics. Following informed
      consent and baseline assessments, participants will be randomly assigned to either an (a)
      integrated HIV treatment adherence - risk reduction intervention or (b) a time-matched
      non-contaminating attention control condition. Participants will be followed for 12-months
      using office-based computerized interviews, unannounced pill counts, and medical chart
      abstraction. The study will test the hypothesis that a unified, integrated theory-based HIV
      treatment and risk reduction intervention will reduce HIV transmission risk behaviors,
      improve HIV treatment adherence, reduce viral load and prevent new STI. The study will also
      examine the influence of theoretical constructs and structural barriers on intervention
      outcomes. Factors that predict relapse to non-adherence and risk behaviors in relation to
      changes in viral load and STI over the 12-month follow-up period will also be a focal point
      of the study. The intervention under investigation will be among the first to simultaneously
      address treatment adherence and risk behavior in an integrated model for substance using HIV
      positive men and women. If shown effective, the intervention model will be ready for
      immediate dissemination to community and clinical services for people living with HIV/AIDS.
    

Intervention name(s): Infectiousness Risk Reduction; General Health Improvement
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Behavioral counseling conducted in one office session followed by 4 cell-phone-based sessions. Counseling is based on models of behavioral self-management and cognitive decision making with the primary aim to increase antiretroviral adherence, engagement in HIV care, and reduction of sexual risk behaviors for HIV transmission.; Educational counseling to help link participants to social serves and health related strategies.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Prevention
Keywords: HIV/AIDS, HIV infectiousness, Medication adherence, Sexual risks reduction