Testing a peer-based symptom management intervention for women living with HIV/AIDS

Abstract

Objective. To test the impact of participation in a peer-based intervention for symptom management for women living with HIV infection on selected outcome measures including, symptom intensity, medication adherence, viral control, and quality of life. Design. Randomized clinical trial. Methods. Participants were recruited using a convenient, consecutive sampling method. Those participants randomized to the experimental condition attended seven, peer-led sessions over seven weeks. Participants randomized to the control condition received a copy of HIV Symptom Management Strategies: A Manual for People Living with HIV/AIDS. Participants completed four surveys assessing change over time in the aforementioned outcome variables. Results. Eighty-nine HIV-infected women followed over 14 weeks and there were no differences between the two groups on baseline demographic variables. Mixed-effects regression indicated no significant difference between groups across time in total symptom intensity score and medication adherence. There was a significant difference between groups across time for two of the nine quality of life scales – HIV Mastery (χ ²=25.08; p<0.005) and Disclosure Worries (χ ²=24.67; p<0.005). Conclusions. In urban-dwelling women living with HIV/AIDS, results suggest that a peer-based symptom management intervention may not decrease symptom intensity or increase medication adherence. There is positive evidence that suggests that the intervention may increase some important aspects of quality of life. However, further research is warranted to elucidate the effect of peer-based interventions in achieving positive self-management outcomes.

Keywords:

• HIV
• AIDS
• peer
• medication adherence
• clinical trial

Acknowledgements

I would like to thank all members of my dissertation committee: William Holzemer, Sally Rankin, Carmen Portillo and Kate Lorig. Their input and assistance with this project was invaluable. I also want to thank Bruce Cooper for his statistical support and Marla Longenecker for her editoral suppport. I also wish to thank all of the community clinic representatives who assisted in the recruitment of the participants of this study: Sona Soha and Deb Royal at the East Bay AIDS Consortium, Gwen Smith at Southeast Health Center, Roland Zepf at Ward 86 in San Francisco General Hospital and Shalini Eddens at WORLD. This project was funded by a training grant from the National Institutes of Health 1F31NR009910, by the 2008 American Nurses Foundation/Western Institute of Nursing Research Grant and by grants from the University of California, San Francisco Graduate Division and the School of Nursing Century Fund.