Testing a peer-based symptom management intervention for women living with HIV/AIDS

Abstract

Objective To test the impact of participation in a peer-based intervention for symptom management for women living with HIV infection on selected outcome measures including, symptom intensity, medication adherence, viral control, and quality of life. Design Randomized clinical trial. Methods Participants were recruited using a convenient, consecutive sampling method. Those participants randomized to the experimental condition attended seven, peer-led sessions over seven weeks. Participants randomized to the control condition received a copy of HIV Symptom Management Strategies: A Manual for People Living with HIV/AIDS. Participants completed four surveys assessing change over time in the aforementioned outcome variables. Results Eighty-nine HIV-infected women followed over 14 weeks and there were no differences between the two groups on baseline demographic variables. Mixed-effects regression indicated no significant difference between groups across time in total symptom intensity score and medication adherence. There was a significant difference between groups across time for two of the nine quality of life scales – HIV Mastery (χ2 = 25.08; p < 0.005) and Disclosure Worries (χ2 = 24.67; p < 0.005). Conclusions In urban-dwelling women living with HIV/AIDS, results suggest that a peer-based symptom management intervention may not decrease symptom intensity or increase medication adherence. There is positive evidence that suggests that the intervention may increase some important aspects of quality of life. However, further research is warranted to elucidate the effect of peer-based interventions in achieving positive self-management outcomes.

Cultural relevance in medication adherence interventions with underrepresented adults: Systematic review and meta-analysis of outcomes

“…From 39,358 potential studies, we identified 55 primary study comparisons from 48 research reports testing interventions to increase MA in underrepresented samples (Anderson et al, 2004; Andrade et al, 2005; Austin, 1986; Babamoto et al, 2009; Bogart et al, 2012; Bogner and de Vries, 2008; Bogner and de Vries, 2010; Burrelle, 1986; Chaisson et al, 2001; Cordasco et al, 2009; DiIorio et al, 2008; DiIorio et al, 2003; Fernandez et al, 2008; Fisher et al, 2011; Freedman, 2007; Gazmararian et al, 2010; Glanz et al, 2012; Harper, 1984; Holzemer et al, 2006; Kalichman et al, 2011; Kellaway and McCrae, 1979; Koenig et al, 2008; Kripalani et al, 2012; Laine et al, 1996; Mann, 2001; Martin et al, 2011; McKenney et al, 1973; McPherson-Baker et al, 2000; Migneault et al, 2012; Moitra et al, 2011; Muir et al, 2012; Mundy, 2009; Murphy et al, 2007; Newsome, 1995; Parsons et al, 2007; Powell, 2002; Purcell et al, 2007; Remien et al, 2005; Simoni et al, 2007; Tagliacozzo et al, 1974; van Servellen et al, 2005; Vivian, 2002; Walker, 2000; Webel, 2010; Weinberger et al, 1991; Werner, 1979; Wohl et al, 2006; Wyatt et al, 2004). The PRISMA flow diagram summarizing study section is found in Figure 1.…”

Guidelines for Improving Entry Into and Retention in Care and Antiretroviral Adherence for Persons With HIV: Evidence-Based Recommendations From an International Association of Physicians in AIDS Care Panel

“…Twenty-seven interventions in the evidence base used individual adherence counseling; of the 25 evaluating adherence, 16 established positive effects (82, 84, 88–90, 93–103), 3 demonstrated as-treated or post hoc effects (83, 85, 104), 3 demonstrated early effects that deteriorated over time (86, 92, 105), and 3 demonstrated no benefit (87, 106, 107). Of the 17 that included biological outcomes, 12 demonstrated no benefit (83–86, 93, 95, 102, 103, 105–108) and 5 demonstrated positive effects (94, 97, 99, 101, 109).…”

Novel Interventions for HIV Self-management in African American Women: A Systematic Review of mHealth Interventions

“…Thus, we were unable to determine if 50% or more of the sample were AA women. Tufts et al / mHealth HIV Self-management 145 (Pinto et al, 2013;van Velthoven et al, 2013;Winstead-Derlega et al, 2012), or did not employ mHealth technologies (Ramanathan, Swendeman, Comulada, Estrin, & Rotheram-Borus, 2013;Webel, 2010;Webel & Higgins, 2012). Fourteen of the 39 HIV self-management ongoing trials identified from clinicaltrials.gov met our inclusion criteria (see Table 1).…”

“…However, most of these interventions required face-to-face interaction and a substantial intensity of resources to deliver the evidence-based, standardized, culturally relevant, and gender-specific health education (Tobias, Downes, Eddens, & Ruiz, 2012;Webel, 2010) that may be most effective for HIV-infected AA women. The time and resources needed to participate in face-to-face programs may limit access and present a barrier to participation (Jaglal et al, 2013;Jerant, von Friederichs-Fitzwater, & Moore, 2005).…”