Behavioral Intervention to Enhance HIV Test/Treat



Status:Completed
Conditions:HIV / AIDS
Therapuetic Areas:Immunology / Infectious Diseases
Healthy:No
Age Range:18 - 100
Updated:5/11/2018
Start Date:February 1, 2012
End Date:February 1, 2018

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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.

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.

Inclusion Criteria:

- Age 18 and older

- HIV positive

- Sexually active in the previous Month

- Active substance use

Exclusion Criteria:
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