Social Network Support for HIV Care

Overseen By Yuri A Amirkhanian, PhD

Age: 18+

Sex: Male

Trial Phase: Academic

Sponsor: Medical College of Wisconsin

Disqualifiers: HIV-negative, Adherent to ART, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 9

100 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on social support and care engagement rather than medication changes.

What data supports the effectiveness of the treatment Individual Care Counseling, Social Support Mobilization for HIV care?

Research shows that strong social support, whether through in-person networks or virtual communities, can improve medication adherence and health outcomes for people living with HIV. Studies indicate that social support interventions, like the microclinic model and online support groups, help people stay engaged in HIV care and maintain better health. ^{1 2 3 4 5}

Is social network support for HIV care safe for humans?

The studies reviewed focus on the benefits of social network support for people living with HIV, such as improved engagement in care and emotional support, but they do not report any safety concerns or adverse effects related to this type of intervention. ^{1 2 6 7 8}

How does the Social Support Mobilization treatment for HIV differ from other treatments?

Social Support Mobilization is unique because it focuses on leveraging social networks and online communities to provide emotional and informational support, rather than relying solely on medical interventions. This approach helps people living with HIV connect with peers and professionals, fostering a supportive environment that can improve engagement in care and reduce feelings of isolation. ^{2 3 6 9 10}

What is the purpose of this trial?

The intervention study will recruit 100 out-of-care HIV+ men who have sex with men in online and in community settings located throughout St. Petersburg, Russia. After completing baseline assessments, participants will be randomized to either an individual care counseling (ICC) comparison condition or ICC plus a social support mobilization (SSM) intervention. In each intervention, participants will attend five main and two booster sessions that underscore the benefits of medical care engagement, counter the effects of internalized intersectional stigma and promote resilience, and help participants develop and mobilize social resources supportive of HIV care. Support mobilization will begin by assisting participants develop care-supportive bonds with other group members, friends who are also living with HIV, and connections made with LGBT and other non-governmental organizations. They will also be guided in developing and expanding supportive links with affirmative friends, family members, and other resources. In this way, the intervention will bolster care-related social support resources, resilience, and feelings of self-worth. Assessments administered at baseline will be repeated 6 and 12 months post-intervention, and in-depth followup interviews will be conducted with a subset of 20 participants to elicit feedback about the intervention experience. The study will investigate whether the SSM intervention will produce greater preliminary evidence of benefit on the primary outcome of medical care attendance in the past 6 months and on secondary outcomes of having undetectable viral load, ART adherence, and psychosocial well-being.

Eligibility Criteria

This trial is for HIV+ men over 18 who have sex with men, haven't visited an HIV care provider in the last 6 months or are less than 95% adherent to their ART medication. It's not for those under 18, not male at birth, HIV-negative or unknown status individuals, those already following treatment well, or participants of a prior pilot test.

Inclusion Criteria

reports being HIV-positive with no HIV medical care visit in the prior 6 months or adhering to <95% of ART medication in the past month

I have had sexual relations with males in the last year.

not a participant in the earlier pilot test of the intervention

Exclusion Criteria

I have not had sexual relations with males in the last year.

reports being HIV-positive with at least one HIV medical care visit in the prior 6 months or reports adherence to >95% of prescribed ART in the past month

reports being HIV-negative or unknown HIV status

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Baseline Assessment

Participants complete baseline assessments including demographic information, health history, and a blood draw for viral load testing

1 day

1 visit (in-person)

Intervention

Participants attend five main intervention sessions and two booster sessions focusing on social support mobilization and resilience building

7 weeks

5 visits (in-person), 2 booster sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment with assessments at 6 and 12 months post-intervention

12 months

2 visits (in-person)

Treatment Details

Interventions

• Individual Care Counseling
• Social Support Mobilization

Trial Overview The study tests if adding social support mobilization (SSM) to individual care counseling (ICC) helps out-of-care HIV+ men engage better with medical care. Participants will attend sessions focused on resilience and developing supportive networks and will be assessed over a year to see if SSM improves attendance at medical appointments and overall health outcomes.

Participant Groups

Group I: Social Support Mobilization Experimental Treatment 1 Intervention

In addition to the post-baseline 20-minute individual counseling session, each participant in this arm will attend five main intervention sessions and two booster sessions that have three inter-related objectives: (1) ensuring that participants understand that viral suppression through ART maintains health and protects others; (2) increasing resilience and feelings of self-worth; and (3) guiding participants in identifying, accessing, and mobilizing social resources for both general psychosocial support and also specific supports for HIV care. For individuals who have potential supports in their social environment, the intervention will seek to mobilize or increase the frequency and quality of interactions with them. For participants who are presently socially isolated or whose social resources are not supportive of HIV care, the intervention will help to build new social ties with potentially supportive life figures.

Group II: Individual Care Counseling Active Control 1 Intervention

After completing the baseline survey, each participant will receive a 20-minute individual counseling session focused on HIV medical care. The session will convey that effective HIV treatment is now available at no cost, protects health, and that most individuals who are in treatment can lead long and healthy lives. Referral will be made and assistance provided in accessing LGBT-friendly HIV medical care, mental health, substance abuse, and other services.

Who Is Running the Clinical Trial?

Medical College of Wisconsin

Lead Sponsor

Trials

645

Recruited

1,180,000+

Findings from Research

The Positive Links smartphone app facilitated social support among 55 participants living with HIV over 8 months, with 52% of analyzed posts providing support, primarily emotional in nature.

Participants reported feeling a sense of connection and support through the app, although some faced technical issues that hindered their full engagement, highlighting the app's potential to improve care for those unable to access in-person support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social Support in a Virtual Community: Analysis of a Clinic-Affiliated Online Support Group for Persons Living with HIV/AIDS. Flickinger, TE., DeBolt, C., Waldman, AL., et al.[2018]

References

1. United States pubmed.ncbi.nlm.nih.gov

The Kanyakla study: Randomized controlled trial of a microclinic social network intervention for promoting engagement and retention in HIV care in rural western Kenya. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Social Support in a Virtual Community: Analysis of a Clinic-Affiliated Online Support Group for Persons Living with HIV/AIDS. [2018]

3. United States pubmed.ncbi.nlm.nih.gov

Social Support Network among People Living with HIV/AIDS in Iran. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Intensity of Social Support Matters: A Latent Class Analysis to Identify Levels of Social Support Associated with Optimal Health Outcomes Among Women Living with HIV. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

The Longitudinal Association between Social Support on HIV Medication Adherence and Healthcare Utilization in the Women's Interagency HIV Study. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

"They're My Go-To People": A Qualitative Study of Support Networks for People Recently Diagnosed With HIV in Queensland, Australia. [2023]

7. England pubmed.ncbi.nlm.nih.gov

"Wan Kanyakla" (We are together): Community transformations in Kenya following a social network intervention for HIV care. [2016]

8. England pubmed.ncbi.nlm.nih.gov

Network support, technology use, depression, and ART adherence among HIV-positive MSM of color. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Exploring the communication of social support within virtual communities: a content analysis of messages posted to an online HIV/AIDS support group. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Sources and types of social support that influence engagement in HIV care among Latinos and African Americans. [2022]