HIV Stigma, Mental Disorder
Conditions
Keywords
MSM, youth, Project Yes, Self-Help+, Project Yes+, internalized stigma, mental disorders, Vietnam
Brief summary
In Vietnam, adolescent and young men who have sex with men (AYMSM) are among those most affected by HIV, and they also experience significant HIV-related mental health and stigma challenges. The study team proposes to adapt Project YES+ to address both mental health and internalized HIV stigma among AYMSM living with HIV in Vietnam. This research will build local capacity and develop networks for collaborative research on mental health and stigma in this population between Vietnam, Zambia and the United States.
Detailed description
The specific aims of this proposal are to (1) adapt Project YES+ to create To-Hieu (I understand) to improve mental health and internalized HIV stigma for AYMSM living with HIV in Vietnam and (2) examine acceptability and feasibility of To-Hieu among AYMSM living with HIV in Vietnam through a pilot randomized controlled trial.
Interventions
BEHAVIORALTo-Hieu (I understand)
Project YES+ was developed from two evidence-based interventions - Project Yes! and Self-Help Plus, based on Social Cognitive Theory (Project Yes!) and Acceptance and Commitment Therapy (Self-Help Plus). The youth-focused intervention component comprises 6 individual sessions with a youth peer mentor, 3 youth group sessions facilitated by a youth peer mentor and 5 group sessions to learn stress management skills. The original intervention was designed for 4 months and involves caregivers. The adaptation of Project YES+ for adolescents and young men who have sex with men living with HIV in Vietnam will make revisions on the content, frequency and delivery format of the intervention.
Sponsors
Hanoi Medical University
Fogarty International Center of the National Institute of Health
Johns Hopkins University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
MALE
Age
16 Years to 24 Years
Healthy volunteers
No
Inclusion criteria
* 16-24 years old Vietnamese; * assigned male sex at birth and identifying as male; * anal intercourse with another man in the last 12 months; * HIV positive status and currently receiving ART at the study sites; * currently living in Hanoi and not moving in the next 12 months; * at least a score of 5 on either the Patient Health Questionnaire (PHQ-9) or Generalized Anxiety Disorder - 7 (GAD-7)
Exclusion criteria
* Being currently enrolled in another HIV intervention; * Severe psychotic disorders or other interfering problems that require specialty care
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Acceptability: Client satisfaction | At the end of the intervention at 4 months. | Scores on the Client Satisfaction Questionnaire (CSQ-8). Total scores range from 8 to 32, with the higher number indicating greater satisfaction. |
| Feasibility: intervention attendance | From enrollment to the end of the intervention at 4 months | Percentage of participants who complete at least 80% of the required sessions of To-Hieu |
| Acceptability: perception of implementation | At the end of the intervention at 4 months. | Acceptability will be assessed qualitatively with exit interviews with AYMSMLH and youth peer mentors |
| Feasibility: Perception of implementation | At the end of the intervention at 4 months | Feasibility will be assessed qualitatively in exit interviews with AYMSMLH and youth peer mentors. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Preliminary effectiveness: changes in mental health symptom severity | Baseline and at the end of the intervention at 4 months | Depression and anxiety symptoms over the past two weeks will be assessed using the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder (GAD-7) questionnaire. PHQ-9 scores range from 0 to 27 and GAD-7 scores range from 0 to 21, with higher scores indicate greater symptom severity. |
| Preliminary effectiveness: Change in percentage of ART adherence | Baseline and at the end of the intervention at 4 months | ART adherence will be assessed as the percentage of prescribed doses taken over the past 4 days, calculated using the self-reported number of missed doses and the total number of prescribed doses during that period. |
| Preliminary effectiveness: HIV viral load | Baseline and at the end of the intervention at 4 months | HIV viral load will be assessed with a test provided by the study or through participants' medical records (if available) |
| Preliminary effectiveness: changes in internalized HIV stigma scores | Baseline and at the end of the intervention at 4 months | Changes in internalized HIV stigma scores will be measured using the 6-item Internalized AIDS-Related Stigma Scale. Scores range from 6 to 24, with higher scores indicate greater internalized stigma. |
| Preliminary effectiveness: changes in sexual minority stigma | Baseline and at the end of the intervention at 4 months | Changes in sexual minority stigma will be assessed using the 7-item, 3-factor Reactions to Homosexuality Scale. Total scores range from 7 to 49, with higher scores indicate lower levels of internalized stigma. |
Countries
Vietnam
Outcome results
None listed