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Objective: We examined factors influencing end-of-life care preferences among persons living with HIV (PLWH). Methods: 223 PLWH were enrolled from 5 hospital-based clinics in Washington, DC. They completed an end-of-life care survey at baseline of the FACE™-HIV Advance Care Planning clinical trial. Findings: The average age of patients was 51 years. 56% were male, 66% heterosexual, and 86% African American. Two distinct groups of patients were identified with respect to end-of-life care preferences: (1) a Relational class (75%) who prioritized family and friends, comfort from church services, and comfort from persons at the end-of-life; and (2) a Transactional/Self-Determination class (25%) who prioritized honest answers from their doctors, and advance care plans over relationships. African Americans had 3x the odds of being in the Relational class versus the Transactional/Self-determination class, Odds ratio = 3.30 (95% CI, 1.09, 10.03), p = 0.035. Males were significantly less likely to be in the relational latent class, Odds ratio = 0.38 (CI, 0.15, 0.98), p = 0.045. Compared to non-African-Americans, African-American PLWH rated the following as important: only taking pain medicines when pain is severe, p = 0.0113; saving larger doses for worse pain, p = 0.0067; and dying in the hospital, p = 0.0285. PLWH who were sexual minorities were more afraid of dying alone, p = 0.0397, and less likely to only take pain medicines when pain is severe, p = 0.0091. Conclusion: Integrating culturally-sensitive palliative care services as a component of the HIV care continuum may improve health equity and person-centered care.

Understanding how religion and spirituality influence health-related quality of life (HRQoL) is important for developing holistic, patient-centered treatment. This study determined distinct latent classes of religiousness/spirituality for adult persons living with HIV (PLWH) and associations between latent class membership and HRQoL. Baseline data was collected from 223 patients in the FAmily CEntered (FACE) Advance Care Planning (ACP) clinical trial for PLWH. Patients completed the Brief Multidimensional Measurement of Religiousness/Spirituality (BMMRS-adapted), Patient Health Questionnaire (PHQ-9), Medical Outcomes Study-HIV Health Survey (MOS-HIV), and the Palliative care Outcome Scale (POS). The optimal number of latent classes was determined by comparing K-Class model with (K-1)-Class model iteratively. The relationship between latent class membership, HRQoL, and demographic characteristics was assessed. Patients were 56.1% male, 86.1% Black, aged 22–77 (M = 50.83), 75.3% were Christian. LCA identified three classes: traditionally religious (35%), privately religious (47.1%), and spiritual but not religious (17.9%). MOS-HIV mental health (p < .001), MOS-HIV quality of life (p = .014), and MOS-HIV health transition (p = .016) scores were significantly higher among patients who were traditionally religious. These patients were more likely to be 40+ years and Black. Patients in the privately religious group had the lowest levels of mental health and HRQoL. Understanding how religiousness and spirituality influence HRQoL can help the medical community develop holistic, patient-centered and culturally sensitive interventions that could improve outcomes for PLWH and potentially mitigate the impact of health disparities within the Black and LGBTQ communities.

Introduction: Metastatic cancer patients report elevated stress levels and unique stressors compared to other adults. This study tested the feasibility and efficacy of a mental health app with comedy content delivered to women living with advanced cancer (WLAC). Methods: The mental health platform Neolth was used as a self-guided intervention for WLAC, ages 18+ years. WLAC were recruited by The Comedy Cures Foundation through a press release, social media posts, an email newsletter, and a video call for participants on the foundation’s website. No compensation was provided to participants. After using the Neolth platform, which included watching comedy content for eight weeks, researchers evaluated engagement, and stress levels using The Perceived Stress Scale -10 (PSS-10), self-efficacy using The New General Self-Efficacy Scale (GSES), and anxiety and depression using The Hospital Anxiety and Depression Scale (HADS-A and HADS-D). Results: 54 WLAC (M = 52.2 years, R = 31-74) from 10 countries and 24 states participated by completing the baseline questionnaire. 20.5% identified as BIPOC and 33.0% had previous experience with a mental health app. 57.4% (N=31) completed the study surveys at Week 4 and Week 8. At Week 8, HADS-D scores decreased 18.1%, PSS-10 scores decreased 15.1%, HADS-A scores decreased by 9.7%, and GSES scores increased 7.6%. Participants spent an average of 116 minutes per week on Neolth with an average of 3.15 logins per week. 43.6% of time spent was completing self-guided relaxation practices and 17.2% watching Comedy Cures Foundation videos from cancer survivor Saranne Rothberg. The 30-day retention on Neolth was 100%, with 60-day retention 83%. Conclusion: This study demonstrated the ability of a mental health app with comedy content to engage and support the mental health of WLAC, presenting a cost-effective intervention. Further examination with a larger sample size is needed to conduct multivariate analyses for enhanced understanding of the role of mobile apps and comedy content in reducing stress, anxiety, and depression for WLAC. Citation Format: Saranne Rothberg, Katherine B. Grill, Claire Wheeler. Implementation and evaluation of a mental health app with comedy content for women living with advanced cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 720.