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Intervention Description
Intervention Package Information
Evaluation Study and Results
References and Contact Information
Intervention Description
Target Population
HIV-positive persons at risk of transmitting
HIV
Goal of Intervention
- Eliminate or reduce sexual transmission risk behavior
- Eliminate or reduce injection drug use risk behaviors
- Improve health care practices and quality of life
Brief Description
Healthy
Living is a 3-module/15-session
intervention that is delivered
one-on-one to people living with HIV.
Each of the 3 modules consists of 5
sessions, and each is designed to
improve quality of life in a different
broad area of health: physical, mental,
and sexual. More specifically, the
modules focus on developing positive
strategies for managing symptoms of
depression, anxiety, complex medication
regimens, injection drug use, and sexual
risk behavior in order to avoid unwanted
consequences for themselves, their
friends, families, and partners. Module
1 (stress, coping, and adjustment),
focuses on quality of life, psychologic
coping, and achieving positive affect
and supportive social relationships.
Module 2 (safer behaviors), centers on
self-regulatory issues, such as avoiding
risky sexual and drug use behavior.
Module 3 (health behaviors), addresses
accessing health services, adherence,
and active participation in medical care
decision making. Sessions have a
standard structure and set of activities
that are tailored to the individual
participant. Psychoeducation,
skills-building exercises, and
cognitive-behavioral techniques (trigger
identification, problem solving, and
goal setting) are included in each
session so the participant can use these
skills independently to effectively meet
challenges in their daily lives. |
Theoretic Basis
Social Action Theory
Intervention Duration
Fifteen 90-minute sessions were grouped
into 3 modules. Each module was
delivered over 2 months, with 3 months
between modules for a total duration of
12 months. Intervention Setting
Private settings in community-based
organizations and clinics
Deliverer
Ethnically diverse, gender-matched female
and male facilitators with experience as
social workers, counselors, therapists, or
community-based service providers
Delivery Methods
- Coping strategies
- Demonstration
- Goal Setting
- Problem-solving
- Role plays
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Intervention Package Information
Intervention materials are available
Center for AIDS Prrvention Studies (CAPS).
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Evaluation Study and Results
The original evaluation study was conducted in Los Angeles and San Francisco,
California; Milwaukee, Wisconsin; and New York City, New York between 2000 and
2004.
Key Intervention Effects
- Reduced unprotected sex acts
with persons of HIV-negative or
unknown serostatus
Study Sample
The baseline study sample of 936
HIV-positive men and women is characterized
by the following:
- 45% African American, 32% White,
15% Hispanic, 8% Other
- 79% Male, 21% Female
- 57% MSM (72% of men are MSM)
- Mean age of 40 years, range:
19-67 years
- 81% completed high school
education or more
Recruitment Settings
Community agencies and medical clinics
Eligibility Criteria
Men and women were eligible if they had
medical documentation of their HIV
infection, and were at least 18 years of
age, free of severe neuropsychologic
impairment or psychosis, not currently
involved in another HIV-related behavioral
intervention study, and self-reported
unprotected intercourse with an HIV-negative
or unknown serostatus partner in the past 3
months, or with an HIV-infected non-primary
partner.
Assignment Method
HIV-positive persons (N = 936) were randomly
assigned to 1 of 2 groups: Healthy Living
intervention (n = 467) or wait-list control
(n = 469).
Comparison Group
The wait-list control group received a
delayed intervention following completion of
the study.
Relevant Outcomes Measured and Follow-up Time
HIV transmission risk acts during
past 3 months (defined as unprotected insertive or
receptive anal or vaginal intercourse with
partners of negative or unknown HIV
serostatus) were measured at 5, 10, 15, 20,
25 months post baseline, which translates to
assessments during the intervention and
approximately 3, 8, and 13 months post
module 3.
Participant Retention
- Healthy Living Intervention:
84% retained at 5 months post baseline
81% retained at 10 months post baseline
78% retained at 15 months post baseline
73% retained at 20 months post baseline
73% retained at 25 months post baseline
- Wait-List Control:
88% retained at 5 months post baseline
84% retained at 10 months post baseline
83% retained at 15 months post baseline
79% retained at 20 months post baseline
81% retained at 25 months post baseline
Significant Findings
- Healthy Living participants reported
significantly fewer HIV transmission
risk acts than the wait-list control
participants at 8 months after the
completion of all three modules (p =
.007).
- Across the four assessments (5 to 25
months post baseline), Healthy Living
participants reported significantly
fewer HIV transmission risk acts than
the wait-list control participants (p =
.007).
Considerationss
- Despite randomized allocation to study arms, there were baseline differences between the intervention and control arms. These differences were statistically adjusted using propensity scores.
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References and Contact Information
- Healthy Living Project Team. (2007).
Effects of a behavioral intervention to
reduce risk of transmission among people
living with HIV: The Healthy Living
Project randomized controlled study.
Journal of Acquired Immune Deficiency
Syndromes, 44, 213-221.
Researcher: Steven F.
Morin, PhD
Center for AIDS
Prevention Studies
University of
California, San Francisco
50 Beale
Street, Suite 1300
San Francisco,
CA, 94105
email:
steve.morin@ucsf.edu
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