Review of Recent Behavioral Interventions Targeting Older Adults Living with HIV/AIDS

Illa, Lourdes; Echenique, Marisa; Bustamante-Avellaneda, Victoria; Sanchez-Martinez, Mario

doi:10.1007/s11904-014-0231-y

Cited by 16 publications

(21 citation statements)

References 40 publications

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“…Exclusion criteria: Participants who (1) have a documented HAND diagnosis of ANI or HAD; (2) have been hospitalised in the past month; (3) are unable to communicate in English; (4) are unable to use a tablet for BTA; or (5) are assessed by the research coordinator to be disruptive to a group therapy setting (eg, due to discriminatory remarks). Justification: MND is chosen instead of ANI or HAD due to the potential for unacceptably high false-positive error rates in ANI36 and the potential null effect from psychosocial interventions for people with HAD 14. As the two arms will address HAND and not HIV, a limit of ≥5 years since HIV diagnosis is set to mitigate the risk that some participants may want to discuss issues associated with a recent HIV diagnosis instead of issues associated with HAND.…”

Section: Methods: Participants Interventions and Outcomesmentioning

confidence: 99%

“…With cognitive decline from normal ageing and other syndemic factors (eg, intersecting HIV and ageing comorbidities), HAND symptoms are amplified and further impair the ageing HIV-infected adult’s ability to cope 13. With the earlier age of impairment and syndemic factors associated with HIV, HAND may be a condition in need of specific psychosocial intervention distinct from what is currently being tested in geriatric adults with dementia 12 14. Yet despite exploratory research on the unique challenges of HAND and a stated community need,11 12 15–17 HAND intervention research in the era of modern cART is limited and the optimal intervention is unclear 13 14…”

Section: Introductionmentioning

confidence: 99%

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Protocol for a pilot randomised controlled trial evaluating feasibility and acceptability of cognitive remediation group therapy compared with mutual aid group therapy for people ageing with HIV-associated neurocognitive disorder (HAND) in Toronto, Canada

et al. 2019

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IntroductionHIV-associated neurocognitive disorder (HAND) may affect 30%–50% of people ageing with HIV. HAND may increase stress and anxiety, and impede coping. Psychosocial group therapy may ameliorate HAND’s symptoms, yet the ideal intervention is unclear. This protocol outlines a pilot randomised controlled trial (RCT)—designed using community-based participatory research—to pilot cognitive remediation group therapy (CRGT) against an active comparator.Methods and analysisThis is a pilot, parallel design, two-arm RCT that will recruit participants diagnosed with the mild neurocognitive disorder form of HAND from a neurobehavioural research unit at a tertiary care hospital in Toronto, Canada. Eligibility criteria include age ≥40 years, known HIV status for 5+ years, English fluency, able to consent and able to attend 8 weeks of group therapy. Eligible participants will be randomised to one of two treatment arms, each consisting of eight-session group interventions delivered once weekly at 3 hours per session. Arm 1 (novel) is CRGT, combining mindfulness-based stress reduction with brain training activities. Arm 2 (active control) is mutual aid group therapy. The primary outcomes are feasibility, measured by proportions of recruitment and completion, and acceptability, determined by a satisfaction questionnaire. The secondary outcome is intervention fidelity, where content analysis will be used to assess facilitator session reports. A between-group analysis will be conducted on exploratory outcomes of stress, anxiety, coping and use of intervention activities that will be collected at three time points.Ethics and disseminationEthical approval was obtained from the Research Ethics Boards of St. Michael’s Hospital and the University of Toronto. Findings will be disseminated through peer-reviewed publications, conference presentations and community reporting. This study could provide insight into design (eg, recruitment, measures) and intervention considerations (eg, structure, content) for a larger trial to lessen the burden of cognitive decline among people ageing with HIV.Trial registration numberNCT03483740

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Section: Methods: Participants Interventions and Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Protocol for a pilot randomised controlled trial evaluating feasibility and acceptability of cognitive remediation group therapy compared with mutual aid group therapy for people ageing with HIV-associated neurocognitive disorder (HAND) in Toronto, Canada

et al. 2019

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“…Society then fosters this idea of "ageism," which overlooks the prevalence and existence of sexual activity among older adults (Emlet, 2006b) due to their purported age. As a result, older women may be less likely to openly discuss sexual activity, substance abuse, or risk for HIV infection with their health care providers (Illa, Echenique, Bustamante-Avellaneda, & Sanchez-Martinez, 2014;Nokes et al, 2009).…”

Section: Ageism and Hiv Transmissionmentioning

confidence: 99%

Women 50 and Older and HIV: Prevention and Implications for Health Care Providers

Coleman¹

2017

J Gerontol Nurs

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The current article discusses the importance of implementing HIV and AIDS education, prevention, and intervention programs that are tailored to women 50 and older and to determine HIV risk factors for this population. A literature search was performed, resulting in 41 relevant articles. The literature underscored the significance of increasing awareness of HIV/AIDS, particularly among older women. HIV risk behaviors and the effect that these behaviors have on HIV transmission and prevention among women 50 and older are described. Prior research findings identified risk categories of older women that may contribute to the transmission of HIV among this particular population, including heterosexual relations, perceived HIV risk, ageism and HIV transmission, biological factors, transfusions, sexual enhancement aids, and health care providers and prevention messages. In addition, previous findings indicate that health care providers have not traditionally targeted women 50 and older for HIV prevention. Health care providers should incorporate discussion of HIV risk and transmission during clinic visits and implement prevention programs that target this population. [Journal of Gerontological Nursing, 43(12), 29-34.].

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“…In the absence of and even alongside an eventual pharmacological remedy, psychosocial approaches are needed to improve coping with HAND's symptoms 17 . Although existing research has illuminated unique cognitive challenges amongst people aging with HIV 18 , such as a higher prevalence of cognitive impairment at an earlier age 19 than the general population and dual stigma associated with HIV and cognitive challenges 20 , psychosocial interventions have not yet been well tested for people aging with HIV and the optimal approach is unknown 21 .…”

Section: Introductionmentioning

confidence: 99%

Cognitive remediation group therapy versus mutual aid group therapy: A pilot randomized, controlled trial to determine the feasibility and acceptability of group therapy for people aging with HIV facing cognitive challenges

Eaton¹,

Craig²,

Rourke³

et al. 2020

Preprint

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Background: Cognitive impairment is an important comorbidity for people aging with HIV, yet we lack non-medical techniques to address the associated anxiety and stress. Combination psychosocial interventions may have better outcomes than single technique approaches. Mindfulness-Based Stress Reduction (MBSR) and tablet-based Brain Training Activities (BTA) are promising techniques. Using community-based participatory research, our objective was to determine the feasibility and acceptability of group therapy for HIV, aging, and cognition.Methods: A pilot, parallel design, two-arm RCT recruited from a Toronto neurobehavioural research unit. Eligibility criteria included: diagnoses with mild-to-moderate HIV-associated neurocognitive disorder (HAND), age ≥ 40 years, HIV-positive for 5+ years, and English fluency. Randomization was 1:1 concealed allocation to Cognitive Remediation Group Therapy (Experimental; combination of BTA and MBSR) or Mutual Aid Group Therapy (Control). Primary outcomes were feasibility, measured by recruitment and completion, and acceptability, determined by a satisfaction questionnaire. The secondary outcome was intervention fidelity, assessed via facilitator session reports. Exploratory outcomes were anxiety, stress, coping, and use of mindfulness and brain training activities.Facilitators and analysts were blinded, however participants were not. eligible participants were contacted, 12 randomized, and 10 completed the study and were analyzed for outcomes. The trial met its a priori feasibility targets with 30% recruited and 25% completed. At post-intervention, acceptability was 90% in the novel and 85% in the control arm. Assessors confirmed intervention delivery with satisfactory fidelity, with no missing components or significant deviations. Anxiety decreased for all in the novel arm and half of the control. Stress decreased and coping increased for half in both arms. All participants increased and sustained BTA use and half with mindfulness activities. There were no reported study harms.Conclusions: Although the combination of BTA and MBSR proved equal or slightly better to mutual aid therapy on all outcomes, recruitment of people with a formal HAND diagnosis from a single site was challenging. We recommend that future exploration of these techniques broaden to those aging with Human Immunodeficiency Virus MBSR Mindfulness-Based Stress Reduction Declarations Ethics approval and consent to participateThis study was approved by the Research Ethics Boards of and the University of Toronto (35860). Informed consent was obtained from all study participants. Consent for publicationNot applicable.

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Review of Recent Behavioral Interventions Targeting Older Adults Living with HIV/AIDS

Cited by 16 publications

References 40 publications

Protocol for a pilot randomised controlled trial evaluating feasibility and acceptability of cognitive remediation group therapy compared with mutual aid group therapy for people ageing with HIV-associated neurocognitive disorder (HAND) in Toronto, Canada

Protocol for a pilot randomised controlled trial evaluating feasibility and acceptability of cognitive remediation group therapy compared with mutual aid group therapy for people ageing with HIV-associated neurocognitive disorder (HAND) in Toronto, Canada

Women 50 and Older and HIV: Prevention and Implications for Health Care Providers

Cognitive remediation group therapy versus mutual aid group therapy: A pilot randomized, controlled trial to determine the feasibility and acceptability of group therapy for people aging with HIV facing cognitive challenges

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