HIV
Conditions
Keywords
HAART, HIV, Adherence
Brief summary
This is a two-phase study, consisting of the following plan: Phase I - This is a pre-test of the feasibility and acceptability of the beta version of a computer-delivered intervention, Motivational Enhancement System for Adherence (MESA), as well as the control intervention Motivational Enhancement System for Health (MESH) at three selected AMTUs. Following analysis of the responses in Phase I and further modification of the intervention, Phase II will be initiated. Phase II - This is a pilot, randomized, controlled trial (RCT) testing a two-session computer-delivered intervention, MESA, designed to increase motivation for adherence to Highly Active Antiretroviral Therapy (HAART) among youth newly recommended to begin medications, as well as an attention control, MESH, matched for dose and delivery format. Phase II is open to all 15 AMTUs.
Interventions
BEHAVIORALMotivational Enhancement System for Adherence (MESA)
MESA is designed to increase motivation for adherence to Highly Active Antiretroviral Therapy (HAART) among youth newly recommended to begin medications.
BEHAVIORALMotivational Enhancement System for Health (MESH)
Motivational Enhancement System for Health (MESH) is an attentional control providing information on nutrition and exercise.
Sponsors
National Institute on Drug Abuse (NIDA)
National Institute of Mental Health (NIMH)
University of North Carolina, Chapel Hill
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
16 Years to 24 Years
Healthy volunteers
No
Inclusion criteria
Phase I & II, all participants * Engaged in care at the enrolling AMTU; * HIV-1 infection documented by a positive result on any of the following licensed tests at any time: any HIV-1 antibody test confirmed by Western blot, HIV-1 culture, HIV-1 DNA PCR, or plasma HIV-1 RNA PCR \> 1,000 copies/ml; * Age 16 to 24 years, inclusive at the time of enrollment; * Naïve to antiretroviral therapy; NOTE: Females who have received antiretroviral therapy for the sole purpose of preventing maternal to child transmission (MTCT) will be considered antiretroviral naïve. * Ability to understand written and/or spoken English; * Willingness to provide signed informed consent/assent in either English or Spanish; and * Parental or legal guardian permission, if warranted. Phase I MESA Participants/Phase II All Participants - Recommended by a health care provider to start HAART for treatment of HIV-1 infection within the 12 weeks prior to protocol screening. Phase I MESH Participants \- Not recommended by a health care provider to start HAART for treatment of HIV-1 infection.
Exclusion criteria
Phase I & II, all participants * Known pregnancy (pregnancy testing is not required); * Inability to understand spoken or written English; * Visibly distraught and/or visibly emotionally unstable (e.g., exhibiting suicidal, homicidal, manic or violent behavior); * Active drug or alcohol use or dependence that, in the opinion of the site personnel, would interfere with ability to give true informed consent and to adhere to the study requirements; * Active psychiatric condition that in the opinion of the site personnel, would interfere with the ability to give true informed consent and to adhere to the study requirements; * Acute illness that, in the opinion of the treating clinician, would interfere with the participant's ability to adhere to the protocol requirements and/or interfere with the protocol objectives; and * Concurrent participation or participation within the previous 4 weeks, in any behavioral intervention study or program, including, but not limited to, ATN 069 and ATN 073. Permission to co-enroll into other behavioral studies or programs must be obtained from the protocol chair or designee. Phase II, All Participants Prior participation in the Phase I MESA intervention (Phase I MESH control participants are eligible to participate).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To assess the feasibility and acceptability of the Motivational Enhancement System for Adherence (MESA) among HIV-infected youth newly beginning HAART; and in an attention control condition plus standard care. | 26 months |
| To compare levels of motivation to adhere and adherence and reductions in HIV-1 viral loads at follow-up among youth randomized to MESA plus standard care versus those randomized to MESH plus standard care. | 26 months |
Secondary
| Measure | Time frame |
|---|---|
| To assess HAART medication knowledge among youth randomized to MESA plus standard care versus those in an attention control condition plus standard care. | 26 months |
| To compare service utilization rates among youth randomized to MESA plus standard care versus those in an attention control condition plus standard care. | 26 months |
| To examine the levels of nutrition and exercise knowledge among youth randomized to MESH plus standard care compared to those randomized to MESA plus standard care. | 26 months |
| To assess levels of motivation and self-efficacy for healthy eating and exercise among youth randomized to MESH plus standard care compared to those randomized to MESA plus standard care. | 26 months |
| To examine self-efficacy for adherence for youth randomized to MESA plus standard care compared to those in an attention control condition plus standard care. | 26 months |
Countries
Puerto Rico, United States
Outcome results
None listed