ResIlience-based Stigma REdUction Program ("Rise-up")
HIV/AIDS, Stigma, Social, Emotional Adjustment
About this trial
This is an interventional prevention trial for HIV/AIDS
Eligibility Criteria
PLWH. The eligibility criteria for PLWH include: 1) at least 18 years of age; 2) a confirmed diagnosis of HIV or AIDS; 3) with a detectable viral load (i.e., viral load≥50 copies/mL) or a viral round during the past year (a confirmed detectable viral load following a suppression); 4) willing to refer or give permission for us to contact one of their adult family member (either of origin or of choice) to participate (but the decision to participate will solely reside in the family member); 5) willing to provide a hair sample for test of hair cortisol and ARV hair concentration; 6) willing to consent the retrieval of their past and recent CD4 count and viral load from their medical charts; and 7) willing to be randomized to intervention condition at different time point in the stepped wedge trial. The exclusion criteria for PLWH include 1) mental or physical inability to respond to assessment questions or to participate in intervention; 2) currently incarcerated or institutionalized for drug use or commercial sex; 3) participating in other intervention activities during the current study period; and 3) plan to permanently relocate outside of the province within a year. Physical and developmental inability will be screened by the local research team in consultation with physicians at the participating clinics.
Family members. The eligibility criteria for family members include 1) at least 18 years of age; 2) either family member of origin or family member of choice who provide emotional and other social support to study PLWH; 3) have been referred by case PLWH to participate in the study; and 4) willing to be randomized (along with study PLWH) to intervention condition. The exclusion criteria for family members will be the same as PLWH. An HIV-infected family member will be eligible to participate. The decision of the family member to or not to participate will not affect the eligibility of PLWH to participate. Based on our experience working with PLWH in Guangxi, we anticipate that at least 80% of the referred family members will participate. With appropriate consent, we will collect brief information (e.g., key demographic characteristics and treatment profiles) on those PLWH who either cannot identify a family member (of origin or of choice) or her/his family member refuses to participate for potential secondary analysis to inform the refinement and scale-up of the proposed intervention in the future.
Health care providers. The eligibility criteria for health care providers include: 1) at least 18 years of age; 2) provides health care services at one of the participating HIV clinics; and 3) has regular contact with HIV-infected patients. The exclusion criteria for health care providers include a plan to permanently relocate outside of the province within a year.
Sites / Locations
- University of South Carolina
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
PLWH intervention sessions
Family member intervention
Health care provider intervention
The PLWH in this arm will receive five 2-hour intervention sessions delivered over five weeks (one session per week) in the clinics. Two trained facilitators will deliver the materials through interactive trainings that include multimedia presentations, group discussions, role-play, personal testimonies, and/or games. The same two facilitators will deliver all five sessions within a clinic to increase group cohesion and rapport with PLWH. The goal of this intervention is to assist PLWH in identifying and developing internal and external resilience resources to aid in coping HIV stigma.
The intervention sessions for family members will be similar to PLWH sessions in terms of format and content and will be led by trained facilitators. Family member intervention sessions will emphasize supporting PLWH to cope with HIV-related stigma and to improve their clinical outcomes. The goal of this intervention is to provide social support for PLWH's resilience building as well as foster resilience at the family level.
The HCP intervention curriculum consists of four 1.5-hour sessions (e.g., one per week) that will be delivered in small groups in the clinic setting by trained facilitators (e.g., health educators from Guangxi CDC). The delivery schedule and format will be flexible and individually tailored (e.g., four sessions can be given one per week or consolidated into two longer sessions). The goal of this intervention is to reduce the institutional stigmatizing attitudes and practices toward PLWH and other social identities, such as MSM, sex workers, and drug users, and improving the provider-patient relationships.