Category: Cultural Diversity / Vulnerable Populations
Keywords: HIV / AIDS | Substance Abuse
Presentation Type: Symposium
Internalized stigma and related emotions are under-addressed barriers to HIV-related self-care, particularly among people who use substances. Innovative approaches are needed to optimize antiretroviral (ART) adherence and engagement in HIV care among this population.We developed and open-piloted a low-cost transdiagnostic emotion regulation intervention to improve HIV self-care among polysubstance users in San Francisco. The intervention included 5 individual sessions and an innovative bidirectional text platform that queried about emotion, ART adherence, and substance use. Individual sessions focused on three themes: behavioral goal setting; awareness of emotions and thoughts; and reappraisal, including cognitive restructuring and compassionate “self-reappraisal.” After each session, participants created compassionate self-reappraisal statements informed by the session content (e.g., “I am more than just a junkie”). For 8 weeks, participants then received their chosen self-reappraisals in response to endorsing the emotion they felt the reappraisal would help cope with, modeling reappraisal as an emotion regulation strategy. For example, if a participant selected, “I am worthy and should take my meds,” to help cope with shame, then he received that statement via text whenever he responded “ashamed” to the daily text emotion query. Of the 9 enrolled HIV+ substance users, 8 completed all sessions and responded to an average of 77% (SD=16%) of texts. Of those who completed exit interviews (n=7), when asked how likely they were to recommend the intervention to a friend and a friend who uses substances (0=not at all-10=definitely), the mean (SD) responses were 9.3(2.0) and 9.7(0.8), respectively. Median (IQR) scores were 10(10,10) and 10(10,10). In qualitative exit interviews all participants reported finding sessions and personalized text messages helpful. These preliminary results also indicated improvements in ART adherence and engagement in HIV care over the course of the intervention. This pilot was determined to be feasible and acceptable among people living with HIV who met criteria for active polysubstance use, a hard-to-reach and underserved population.
Massachusetts General Hospital/Harvard Medical School, University of California, San Francisco
Saturday, November 18
10:15 AM – 11:45 AM
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