Increasing Social Support to Improve HIV Care Engagement and Adherence in St. Petersburg, Russia

Completed · Not applicable

Conditions studied: HIV, AIDS

In brief

Prior research has documented serious health, mental health, and social-behavioral issues among people living with HIV (PLH) in St. Petersburg. The investigators have established that PLH are clustered in friendship groups with other HIV+ persons and that an intervention delivered to groups composed of HIV+ men who have sex with men (MSM) who were friends in real life reduced mental health distress more than individual counseling. Specific aims of the collaborative mixed-methods, qualitative/ quantitative research are to: (1) identify facilitators and barriers of medical care attendance and ART adherence among PLH in St. Petersburg; (2) integrate these data into an intervention designed to increase HIV care attendance, retention, and adherence; (3) carry out a test-of-concept pilot study that recruits groups of PLH friends and delivers an intervention to intact PLH friendship groups to encourage mutual social support for attending medical appointments and adhering to HIV care; and (4) evaluate the effects of the intervention on both behavioral and biological measures, including viral load. These specific aims will be achieved by research carried out in two phases: In Phase I, we will conduct in-depth interviews with 60 PLH and key informants in St. Petersburg purposively selected to include HIV+ persons in and not in medical care, adherent or not adherent to ART, and including men and women representing diverse exposure risks. In-depth interviews will be analyzed to identify factors associated with attending or not attending care and adhering or not adhering to ART, as well as identifying how HIV+ friends can support one another in HIV care entry, retention, and adherence. In Phase II, the investigators will undertake a randomized intervention pilot study in which 20 groups of PLH friends are recruited by enrolling a PLH seed who is not reliably in care or is ART nonadherent and then recruiting all friends known by the seed to also be HIV+. A 7-session group intervention will be undertaken with all members of the friendship groups in the experimental condition to increase care and adherence-related social support, problem-solving, and mutual assistance for care. Baseline to 6-month followup data will determine whether the intervention produces greater improvement than found in the comparison group in care attendance and treatment adherence, improved mental health, lower substance use, and lower HIV viral load.

Key facts

Study ID: NCT02167828
Run by: Medical College of Wisconsin
People needed: 174
Starts: 2014-06-01
Expected to finish: 2019-07-08
Last updated by the study team: 2019-10-07

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Age 18 or older
Self-report as being HIV-positive
Except for initial seeds, must be named by an already-enrolled participant as an HIV-positive friend
Do not plan to move from the St. Petersburg area for the next 12 months
Able to provide written informed consent and do not exhibit severe alcohol intoxication, drug use impairment, or acute psychiatric impairment.

You may not qualify if…

Age 17 or younger
Self-report as HIV-negative
Not named as an HIV-positive friend by an already-enrolled participant
Plans to move from the St. Petersburg area in the next 12 months
Exhibit severe alcohol intoxication, drug use impairment, or acute psychiatric impairment

Where it is running

Center for AIDS Intervention Research, Medical College of Wisconsin — Milwaukee, Wisconsin, United States
Botkin Hospital for Infectious Diseases #30 — Saint Petersburg, Russia

Full record on ClinicalTrials.gov

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