144 Participants Needed

Employment Reinforcement Strategies for HIV/AIDS

RF
Overseen ByRuth Fetter
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: UConn Health
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the idea that Employment Reinforcement Strategies for HIV/AIDS is an effective treatment?

The available research shows that Employment Reinforcement Strategies, also known as Contingency Management, can be effective for people with HIV/AIDS. In one study, participants who received this treatment were more likely to achieve viral load suppression, which means the amount of HIV in their blood was reduced. Another study at an HIV drop-in center found that using this treatment increased attendance and activity completion rates. Although there are fewer studies specifically on HIV, similar strategies have been successful in helping people with substance use disorders by encouraging drug abstinence and improving treatment attendance. This suggests that the treatment can be beneficial for managing HIV-related behaviors as well.12345

What data supports the effectiveness of the treatment Activity Contracting, Contingency Management for Activity Completion, Contingency Management, Reinforcement Therapy for HIV/AIDS?

Research shows that contingency management (CM) can effectively improve behaviors related to HIV management, such as medication adherence and attendance at health appointments. Studies have also demonstrated that CM can enhance outcomes in substance use treatment and vocational rehabilitation by providing incentives for meeting specific goals, suggesting its potential effectiveness in supporting employment and health behaviors in individuals with HIV/AIDS.12345

What safety data exists for Employment Reinforcement Strategies for HIV/AIDS?

The research indicates that Contingency Management (CM), which is related to Employment Reinforcement Strategies, is an evidence-based intervention primarily used for substance use disorders. It has been shown to be effective in reducing drug use and HIV risk behaviors. CM has been applied to reinforce non-drug-related activities, including employment-related tasks, and has been integrated into multi-target interventions for HIV-positive individuals. While the studies focus on efficacy, they do not explicitly address safety concerns, suggesting that CM is generally considered safe as it involves positive reinforcement strategies.16789

Is contingency management safe for humans?

Contingency management (CM) has been used safely in various studies to encourage positive behaviors, such as abstaining from drug use and attending health appointments. It involves providing rewards for meeting specific goals and has been integrated into different treatment programs without reported safety concerns.16789

Is the treatment Activity Contracting, Contingency Management for Activity Completion a promising treatment for helping people with HIV/AIDS return to work?

Yes, the treatment is promising because it focuses on helping people with HIV/AIDS reenter the workforce, which can improve their health and social outcomes. Employment is a key factor in better health and preventing HIV transmission, and this treatment aims to support people in achieving these benefits.1011121314

How does the treatment 'Activity Contracting, Contingency Management for Activity Completion' differ from other treatments for HIV/AIDS?

This treatment is unique because it focuses on using employment reinforcement strategies, such as setting goals and providing rewards for completing activities, to help people with HIV/AIDS reenter the workforce, which is different from traditional medical treatments that primarily focus on managing the virus itself.1011121314

What is the purpose of this trial?

Many persons living with HIV/AIDS (PLWHA) are unemployed, with estimates indicating rates as high as 60%. This study will examine the efficacy of reinforcing job-acquisition activities for improving employment outcomes in PLWHA who desire to return to the workforce in part- or full-time capacity. In total, this study will randomly assign 144 unemployed PLWHA to one of two interventions. All participants will receive usual unemployment services with an emphasis on specific issues related to HIV/AIDS, plus encouragement for completing activities geared toward employment readiness and acquisition. The enhanced intervention will involve that same treatment plus chances to win prizes for engaging in job-related activities each week. Participants will receive study treatments for 16 weeks and complete follow-up evaluations throughout 18 months. The hypothesis is that participants reinforced for completing job-related activities will transition to employment at higher and faster rates and work more often than those who are not reinforced for job-related activities.

Research Team

CR

Carla Rash, Ph.D.

Principal Investigator

UConn Health

Eligibility Criteria

This trial is for adults over 18 who are HIV positive and currently unemployed, not participating in the formal economy. It's designed to help them get back into work. People with conditions that could interfere with their participation in the study cannot join.

Inclusion Criteria

not working in the formal economy
HIV positive

Exclusion Criteria

You have a medical condition that could make it difficult for you to participate in the study.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive usual unemployment services with an emphasis on specific issues related to HIV/AIDS, plus encouragement for completing activities geared toward employment readiness and acquisition. The enhanced intervention includes chances to win prizes for engaging in job-related activities each week.

16 weeks

Follow-up

Participants complete follow-up evaluations to assess employment outcomes, quality of life indices, physical and cognitive functioning, psychological symptoms, viral loads, and drug use and risk behaviors.

18 months

Treatment Details

Interventions

  • Activity Contracting
  • Contingency Management for Activity Completion
Trial Overview The study tests two methods to improve job acquisition for people living with HIV/AIDS. Everyone gets standard unemployment services plus encouragement for job readiness activities. One group also gets chances to win prizes as extra motivation for completing these activities.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: Reinforcement for completing activitiesExperimental Treatment2 Interventions
Standard services plus job activity contracting plus reinforcement for completing job-related activities
Group II: Job activity contractingActive Control1 Intervention
Standard services plus job activity contracting

Find a Clinic Near You

Who Is Running the Clinical Trial?

UConn Health

Lead Sponsor

Trials
218
Recruited
59,100+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials
2,658
Recruited
3,409,000+

Findings from Research

A novel multi-target contingency management (CM) program was developed for HIV positive substance users, integrating various health and behavior targets to improve outcomes over a 6-month period.
The primary goal of the program is to achieve viral load suppression at 12 months, with participants able to earn up to $1160 through completing tasks related to health care visits, medication adherence, and drug use abatement, indicating a comprehensive approach to managing both health and substance use behaviors.
Development of a Multi-Target Contingency Management Intervention for HIV Positive Substance Users.Stitzer, M., Calsyn, D., Matheson, T., et al.[2019]
The group-based contingency management intervention at an HIV drop-in center significantly increased attendance from an average of 0.7 clients per session during the baseline phase to 7 clients during reinforcement phases over 35 weeks.
The intervention also improved the completion of treatment-related activities, rising from 25% during baseline to 65% during reinforcement phases, demonstrating its effectiveness in promoting engagement in treatment.
Contingency management in group treatment: a demonstration project in an HIV drop-in center.Petry, NM., Martin, B., Finocche, C.[2021]
In a study of 19 veterans undergoing vocational rehabilitation, those who received enhanced financial incentives for meeting clinical goals were more successful in job-search activities and remained abstinent from drugs and alcohol compared to those who did not receive incentives.
Participants in the incentive group not only secured competitive employment more frequently but also earned an average of 68% more in wages, indicating that adding financial rewards can significantly improve rehabilitation outcomes.
The impact of enhanced incentives on vocational rehabilitation outcomes for dually diagnosed veterans.Drebing, CE., Van Ormer, EA., Krebs, C., et al.[2019]

References

Development of a Multi-Target Contingency Management Intervention for HIV Positive Substance Users. [2019]
Contingency management in group treatment: a demonstration project in an HIV drop-in center. [2021]
The impact of enhanced incentives on vocational rehabilitation outcomes for dually diagnosed veterans. [2019]
Contingency management for treatment of substance abuse. [2019]
Contingency management interventions for HIV-related behaviors. [2019]
A community-engaged randomized controlled trial of an integrative intervention with HIV-positive, methamphetamine-using men who have sex with men. [2019]
Reinforcing compliance with non-drug-related activities. [2019]
Contingency management reduces drug-related human immunodeficiency virus risk behaviors in cocaine-abusing methadone patients. [2021]
Contingency management: utility in the treatment of drug abuse disorders. [2019]
10.United Statespubmed.ncbi.nlm.nih.gov
Helping people with HIV/AIDS return to work: a randomized clinical trial. [2022]
11.United Statespubmed.ncbi.nlm.nih.gov
A Critical Review of Health, Social, and Prevention Outcomes Associated With Employment for People Living With HIV. [2019]
Impact of conditional economic incentives and motivational interviewing on health outcomes of adolescents living with HIV in Anambra State, Nigeria: A cluster-randomised trial. [2022]
13.United Statespubmed.ncbi.nlm.nih.gov
A cross-lagged longitudinal investigation of the relationship between stigma and job effectiveness among employees with HIV. [2023]
Examining the role of vocational rehabilitation on access to care and public health outcomes for people living with HIV/AIDS. [2019]
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