Improving the Health and Mental Health of People Living With HIV/AIDS: 12-Month Assessment of a Behavioral Intervention in Thailand

Abstract

Objectives-. People living with HIV (PLH) in Thailand face multiple stressors. We examined findings from a randomized controlled intervention trial designed to improve the quality of life of PLH in Thailand. Methods-.A total of 507 PLH were recruited from four district hospitals in northern and northeastern Thailand and were randomized to an intervention group (n = 260) or a standard care group (n = 247). Computer-assisted personal interviews were administered at baseline, 6, and 12 months.Results-At baseline, the characteristics of PLH in the intervention and the standard care condition were comparable. The mixed effects models used to assess the effect of the intervention revealed that PLH in the intervention condition reported significant improvement in their general health (β = 2.51, P = .001) and mental health (β = 1.57, P = .02) over 12 months, compared to those in the standard care condition.Conclusions-We demonstrated successful efficacy of an intervention designed to improve the quality of life of PLH in Thailand. Interventions must be performed in a systematic, collaborative manner to ensure their cultural relevance, sustainability, and overall success.Corresponding Author: Li Li, PhD, UCLA Semel Institute, Center for Community Health, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA 90024, USA, Phone: (310) 794-2446; Fax: (310) 794-8297; lililili@ucla.edu. About the AuthorsAt the time of the study, Li Li, Sung-Jae Lee, and Mary Jane Rotheram-Borus were with the University of California, Los Angeles, Semel Institute Center for Community Health. Chuleeporn Jiraphongsa, Siwaporn Khumtong, Sopon Iamsirithaworn, and Panithee Thammawijaya were with the Thai Ministry of Public Health, Bureau of Epidemiology, Nonthaburi, Thailand. Contact information for reprint requestsRequests for reprints should be sent to Li Li, University of California, Los Angeles, Semel Institute Center for Community Health, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA 90024 (lililili@ucla.edu). ContributorsLi Li contributed to the conception and design of the study and led the study implementation and the writing of the article. Sung-Jae Lee contributed to the summarization and interpretation of study results and data analysis. Mary Jane Rotheram contributed to the conception and design of the study and the interpretation of the study results. Chuleeporn Jiraphongsa, Siwaporn Khumtong, Sopon Iamsirithaworn, and Panithee Thammawijaya contributed to the data collection activities in Thailand, and contributed to the interpretation of the study results. People living with HIV/AIDS (PLH) in Thailand face multiple challenges, including coping with HIV-related disclosure, stigma, and maintaining positive family relationships. HIV disclosure has been identified as a key stressor for PLH in Thailand, with disclosure to children being only 20%, 1 yet 85% to partners. 2,3 When PLH do not disclose their serostatus, the odds of becoming depressed increase threefold, similar to the rate when family members are ashamed of an HIV-positive...

Parenting styles and emotional intelligence of HIV-affected children in Thailand

“…This study uses data from a randomized controlled family intervention trial in Thailand (Li et al, 2010; Li et al, 2012). Initial screenings of children of PLH were conducted in the district hospitals by healthcare workers and research staff.…”

Shame among people living with HIV: a literature review

“…Four studies have directly assessed shame among PLWH, and each reported a medium to large effect size between shame and depressive symptoms (Bennett, Hersh, Herres, & Foster, 2015; DeMarco, 1998; Li et al, 2010; Rodkjaer, Laursen, Balle, & Sodemann, 2010). These studies of American, Danish, and Thai PLWH included adolescents through older adults, and both men and women.…”

“…Shame also predicted worse physical health a year later among PLWH (Li et al, 2010) and is associated with greater physical symptoms and reduced health-related quality of life among PLWH in cross-sectional studies (DeMarco, 1998; Persons, Kershaw, Sikkema, & Hansen, 2010). …”

AIDS and Trauma: Adults, Children and Orphans

“…Most CBIs have been implemented in the U.S. and other wealthy nations; however, a few studies of CBI in less wealthy nations have yielded promising results. For example, in Thailand, a study of a culturally adapted CBI demonstrated improvement in general health and mental health (Li et al, 2010). Integrating behavioral interventions with HIV care for HIV-positive individuals with co-morbid mental health and substance use disorders significantly reduces psychiatric symptoms and improves medication adherence (K. Whetten et al, 2006).…”