Increasing Motivation for Antiretroviral Therapy Initiation: A Pilot Intervention
Condition: HIV
Study type: Interventional

Summary: 
      In this 3-year study, the investigators will develop and pilot test an intervention called
      Personal Approaches to Treatment Choices for HIV (PATCH). PATCH is a brief intervention
      designed to support participants' decision-making processes and enhance intrinsic motivation
      to initiate ART, using motivational interviewing (MI) techniques. The intervention will be
      targeted at HIV-positive African-American adults in inner-city Baltimore, Maryland who are
      suboptimally engaged in care and who endorse conspiracy beliefs about HIV or low readiness to
      begin ART. The specific aims are: (1) Develop and refine a manual for a brief MI intervention
      to support ART decision-making and reduce the likelihood of ART refusal: (2) Evaluate the
      feasibility and acceptability of implementing the PATCH intervention in a small sample of
      individuals who are African-American, recommended for ART but who are not current taking it,
      and who experience multiple barriers to ART adherence; and (3) Conduct a small randomized
      controlled pilot to test the potential efficacy of the PATCH intervention in producing
      positive attitudinal changes, including a reduction in conspiracy beliefs and perceived
      barriers to ART and stated readiness to begin ART.
    

Detailed description: 
      Many persons with HIV refuse recommended treatment or delay initiation of antiretroviral
      therapy (ART). Widespread belief in conspiracy theories regarding the origin and treatment of
      HIV may complicate the ART decision-making process. Research has found that conspiracy
      beliefs and mistrust in the mainstream medical system are common among African-Americans
      attending an HIV primary care clinic and that conspiracy beliefs are more likely to be held
      by patients who are not on ART. Moreover, research shows that conspiracy beliefs and other
      maladaptive cognitions predict subsequent readiness to begin ART. The investigators have
      developed an intervention called PATCH: Personal Approaches to Treatment Choices for HIV.
      PATCH is a brief intervention designed to support participants' decision-making processes and
      enhance intrinsic motivation to initiate ART, using motivational interviewing (MI)
      techniques. The intervention targets HIV-positive African-American adults in inner-city
      Baltimore, Maryland who are suboptimally engaged in care and who endorse conspiracy beliefs
      about HIV or low readiness to begin ART.

      In this project the investigators will conduct a small randomized controlled pilot trial to
      test the potential efficacy of PATCH in producing positive attitudinal changes, including a
      reduction in conspiracy beliefs and perceived barriers to ART and an increase in stated
      readiness to begin ART. The investigators will compare PATCH to an attentional control.
      Participants will be recruited from outpatient HIV clinics settings but will be individuals
      who are not taking ART. Assessments will be conducted at baseline, post-treatment (estimated
      4-8 weeks post-baseline), and at 3-month post-baseline follow-up. The specific aims are: (1)
      Develop and refine a manual for a brief MI intervention to support ART decision-making and
      reduce the likelihood of ART refusal: (2) Evaluate the feasibility and acceptability of
      implementing the PATCH intervention in a small sample of individuals who are
      African-American, recommended for ART but who are not current taking it, and who experience
      multiple barriers to ART adherence; and (3) Conduct a small randomized controlled pilot to
      test the potential efficacy of the PATCH intervention in producing positive attitudinal
      changes, including a reduction in conspiracy beliefs and perceived barriers to ART and stated
      readiness to begin ART.
    

Intervention name(s): Personal Approaches to Treatment Choices for HIV; Stress Reduction Skills Program
Intervention type(s): Behavioral; Behavioral
Other intervention name(s): PATCH; SRSP
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment