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Pilot Randomized Controlled Trial of Acceptance-Based Behavior Therapy to Promote HIV Acceptance, HIV Disclosure, and Retention in Medical Care

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Abstract

HIV patients who are not retained in medical care risk viral resistance, disease progression to AIDS, and mortality. Numerous interventions have been tested to improve retention, but they are limited by their resource-intensive approaches and lack of focus on new patients, who are at highest risk for drop-out. Data show that acceptance and disclosure of HIV status might impact retention, yet these variables have not been targeted in previous interventions. In this pilot randomized controlled trial, we assessed feasibility, acceptability, and preliminary efficacy of a brief, 2-session acceptance based behavior therapy (ABBT), relative to treatment-as-usual (TAU), in 34 new-to-care HIV patients. ABBT attendance was high and patient feedback was positive. Relative to TAU, ABBT had significant positive effects on retention, as well as putative mechanisms of action, including experiential avoidance of HIV, willingness to make and actual disclosures of HIV status, and perceived social support. Further testing of ABBT is warranted. Trial registered at clinicaltrials.gov; Clinical Trial #NCT02004457.

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Funding

Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under Award Number R34 MH098694 to Drs. Moitra and Stein. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA

    Ethan Moitra & Philip A. Chan

  2. Louisiana State University - Health Sciences Center, New Orleans, LA, 70112, USA

    Andrea LaPlante & Megan L. Armstrong

  3. The Miriam Hospital, Providence, RI, 02906, USA

    Philip A. Chan

  4. Butler Hospital, Providence, RI 02906, USA

    Michael D. Stein

  5. Boston University School of Public Health, Boston, MA, 02118, USA

    Michael D. Stein

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  1. Ethan Moitra
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  2. Andrea LaPlante
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  3. Megan L. Armstrong
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  4. Philip A. Chan
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  5. Michael D. Stein
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Correspondence to Ethan Moitra.

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All procedures involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Moitra, E., LaPlante, A., Armstrong, M.L. et al. Pilot Randomized Controlled Trial of Acceptance-Based Behavior Therapy to Promote HIV Acceptance, HIV Disclosure, and Retention in Medical Care. AIDS Behav 21, 2641–2649 (2017). https://doi.org/10.1007/s10461-017-1780-z

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