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 (chi(2)=25.08; p<0.005) and Disclosure Worries (chi(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.

Figure 1

Flowchart of participants.

Figure 2

Line graphs of mean scores with 95% confidence intervals for the sign and symptom checklist-HIV revised and the percentage of missed HAART doses by group and time period. (a) SSC-HIV(rev) mean scores with 95% confidence intervals by group at baseline and weeks 6, 10, and 14. Higher scores indicate worse symptom intensity in the past 24 hours when 0 = no symptoms; 1 = mild symptoms; 2 = moderate symptoms; and 3 = severe symptoms. Error bars indicate 95% confidence interval of the mean (standard error of the mean). Intervention sessions occurred during weeks 2–8. (b) Mean percentage of missed HAART doses in the past week with 95% confidence intervals at baseline and week 6, 10, and 16. Error bars indicate 95% confidence interval. Intervention sessions occurred during weeks 2–8.