Resilience-Based Intervention for HIV/AIDS Stigma

Overseen By Xiaoming Li, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of South Carolina

Disqualifiers: Incarceration, Institutionalization, Relocation, others

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

Compensation: Varies

Number of Visits: 14

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to address the stigma and discrimination that people living with HIV/AIDS often encounter, which can hinder effective treatment and care. It tests a resilience-based approach by helping patients, their families, and healthcare providers build strengths and resources to cope with stigma. The trial includes various interventions for each group, focusing on improving patient outcomes like viral suppression (reducing the amount of HIV in the blood). This trial suits individuals diagnosed with HIV who have struggled to maintain a low viral load and are willing to involve a supportive family member. As an unphased trial, it offers a unique opportunity to contribute to innovative strategies that could enhance the quality of life for many.

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 is best to discuss this with the trial coordinators or your healthcare provider.

What prior data suggests that this resilience-based intervention is safe for participants?

Research has shown that programs designed to build resilience, such as those for family members, healthcare providers, and people living with HIV (PLWH), are generally manageable for participants. Studies have found these programs can effectively reduce stigma without causing harm. For instance, a review found that 14 out of 19 similar programs successfully reduced HIV stigma, indicating safety and effectiveness.

In healthcare settings, reducing stigma often involves training sessions for providers. These sessions have improved attitudes without negative effects. Healthcare workers must understand and change behaviors that contribute to stigma to enhance patient care.

For PLWH, programs focus on building resilience and coping with stigma. This approach helps individuals find strength and support, leading to better health outcomes. Research has not reported any major safety concerns with these methods.

Overall, while the success of these programs can vary, they are considered safe for participants. This is important for anyone considering joining a trial focused on reducing HIV-related stigma. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Resilience-Based Intervention for HIV/AIDS stigma because it takes a comprehensive approach to address stigma from multiple angles. Unlike standard care options that typically focus on medical treatment alone, this intervention involves the entire support system of people living with HIV (PLWH), including family members and healthcare providers. The intervention uniquely aims to build resilience through interactive sessions that promote social support and reduce stigma-related attitudes within families and healthcare environments. By fostering resilience at both the individual and community levels, this approach has the potential to significantly improve the quality of life and clinical outcomes for PLWH.

What evidence suggests that this trial's interventions could be effective in reducing HIV-related stigma?

Research has shown that programs focused on building resilience can help reduce the stigma associated with HIV. In this trial, participants may receive one of several interventions. The Family Member Intervention includes support sessions that help people living with HIV (PLWH) cope better, leading to improved health outcomes. Another arm, the Healthcare Provider Intervention, focuses on community programs involving healthcare providers, which have successfully reduced stigma and improved relationships between patients and providers. The PLWH Intervention offers resilience-building sessions that effectively reduce stigma and help participants adhere to their treatment plans. These approaches aim to empower individuals and their families to build strength and resources to fight stigma effectively. ^{3 4 5 6 7}

Who Is on the Research Team?

Xiaoming Li, PhD

Principal Investigator

University of South Carolina

Are You a Good Fit for This Trial?

The 'Rise-up' trial is for adults over 18 with HIV or AIDS, a detectable viral load, and willing to involve a family member. They must be able to provide hair samples, allow medical chart access, and not plan on relocating soon. Those mentally or physically unable to participate or involved in other studies are excluded.

Inclusion Criteria

I am over 18, support someone with HIV, referred by them, and open to study participation.

I am over 18, work at a participating HIV clinic, and regularly see HIV patients.

Exclusion Criteria

I am not in jail, planning to move, or in another study, and can participate fully.

Family members: Same as PLWH criteria

Health care providers: Plan to permanently relocate outside of the province within a year

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention Development

Development of a multilevel resilience-based intervention engaging PLWH, their family members, and healthcare providers

Not specified

Intervention Implementation

Implementation of the resilience-based intervention via a stepped wedge cluster randomized trial

36 months

7 waves of follow-up

Follow-up

Participants are monitored for changes in viral load, CD4 counts, and other clinical outcomes

36 months

7 waves of follow-up

What Are the Treatments Tested in This Trial?

Interventions

• Family member intervention
• Healthcare provider intervention
• PLWH intervention

Trial Overview This study tests a resilience-based intervention aimed at reducing HIV-related stigma among patients, their families, and healthcare providers in China. It uses a stepped-wedge design to measure outcomes like viral suppression and treatment adherence.

How Is the Trial Designed?

Group I: PLWH intervention sessions Experimental Treatment 1 Intervention

The PLWH in this arm will receive five 2-hour intervention sessions delivered over five weeks (one session per week) in the clinics. Two trained facilitators will deliver the materials through interactive trainings that include multimedia presentations, group discussions, role-play, personal testimonies, and/or games. The same two facilitators will deliver all five sessions within a clinic to increase group cohesion and rapport with PLWH. The goal of this intervention is to assist PLWH in identifying and developing internal and external resilience resources to aid in coping HIV stigma.

Group II: Health care provider intervention Experimental Treatment 1 Intervention

The HCP intervention curriculum consists of four 1.5-hour sessions (e.g., one per week) that will be delivered in small groups in the clinic setting by trained facilitators (e.g., health educators from Guangxi CDC). The delivery schedule and format will be flexible and individually tailored (e.g., four sessions can be given one per week or consolidated into two longer sessions). The goal of this intervention is to reduce the institutional stigmatizing attitudes and practices toward PLWH and other social identities, such as MSM, sex workers, and drug users, and improving the provider-patient relationships.

Group III: Family member intervention Experimental Treatment 1 Intervention

The intervention sessions for family members will be similar to PLWH sessions in terms of format and content and will be led by trained facilitators. Family member intervention sessions will emphasize supporting PLWH to cope with HIV-related stigma and to improve their clinical outcomes. The goal of this intervention is to provide social support for PLWH's resilience building as well as foster resilience at the family level.

Who Is Running the Clinical Trial?

University of South Carolina

Lead Sponsor

Trials

233

Recruited

122,000+

Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control

Collaborator

Trials

7

Recruited

11,900+

Published Research Related to This Trial

The community intervention in South Africa effectively reduced HIV stigma among people living with HIV (PLWH) and those close to them, enhancing relationships and increasing willingness to disclose HIV status.

Participants reported improved knowledge about stigma and coping strategies, empowering them to lead stigma reduction efforts in their communities, indicating a positive impact on community awareness and support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A comprehensive HIV stigma-reduction and wellness-enhancement community intervention: a case study. French, H., Greeff, M., Watson, MJ., et al.[2015]

Citations

1. systematicreviewsjournal.biomedcentral.com systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-024-02751-6

Community-based interventions against HIV-related stigma Background. HIV-related stigma remains a key barrier to the attainment of the UNAIDS global goal of ending AIDS by 2030.

2. sciencedirect.com sciencedirect.com/science/article/pii/S1025984815000344

A HIV stigma reduction intervention for people living with ... In a review by Sengupta, Banks, Jonas, Miles, and Smith (2011), 14 out of 19 interventions demonstrated effectiveness in reducing the stigma of HIV and AIDS.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12007456/

Interventions and Their Effectiveness to Reduce HIV ... The protocol was registered in PROSPERO (CRD42024571145). Keywords: gender equality, HIV/AIDS, reduced inequalities, stigma, well‐being, women's ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12068570/

Interventions for stigma reduction in HIV treatment and ... HIV-related stigma finds its origins in the fear and adverse public reactions during the initial AIDS epidemic [16]. HIV-related stigma is ...

5. frontiersin.org frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.857635/full

A Resilience-Based Intervention to Mitigate the Effect of ... A collection of studies in the 2020 AIDS special issue titled “Reducing stigma and discrimination: innovation in measurement and practice” also ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7343253/

Stigma Reduction Interventions in People Living with HIV ... Personal contact “humanizes” a person with a stigmatized condition and subsequently reduces individual-level manifestations of stigma, i.e. the immediate ...

7. viivhealthcare.com viivhealthcare.com/hiv-community-engagement/hiv-stigma/

Breaking the stigma surrounding HIV The Mediating Roles of Internalized and Anticipated HIV Stigma in the Effects of Perceived Community Stigma on Health and Psychosocial Outcomes. AIDS Behav.