JMIR Publications

ABSTRACT

Background:

People living with HIV/AIDS (PLWH) face multiple challenges that collectively impede their adaptation outcomes. While existing evidence addresses specific challenges, it often overlooks the interactions among the various problems PLWH encounter. The comprehensive-task disease management framework and positive self-management framework provide a theoretical basis for understanding the adaptation process. A culturally tailored, theory-based intervention may be necessary and effective in facilitating better adaptation outcomes for PLWH.

Objective:

This study aimed to evaluate the effect of a hybrid intervention called AiCare (Adaptation intervention with Comprehensive-task disease management framework to achieve re-normal life) on improving quality of life, acceptance of illness, mental health outcomes (anxiety and depression), and antiretroviral therapy (ART) adherence among PLWH in China.

Methods:

We conducted a two-arm randomized controlled trial, recruiting 92 PLWH from an HIV clinic in Hunan, China. Participants were randomly assigned to either the control group (receiving standard care) or the intervention group (receiving AiCare in addition to standard care) in a 1:1 ratio. Sociodemographic and HIV-specific clinical characteristics, along with key adaptation outcomes—including quality of life, acceptance of illness, mental health (anxiety and depression), and ART adherence—were assessed at baseline, post-intervention, and at a three-month follow-up. We used generalized estimating equation models and difference-in-difference analysis to evaluate the effects.

Results:

The study enrolled a total of 92 participants. The hybrid intervention group demonstrated significant enhancements in quality of life (β=6.345, 95% CI: 2.620-10.933), acceptance of illness (β=4.485, 95% CI: 2.292-6.677), and anxiety (β=1.984, 95% CI: 0.630-3.338), with no effect on depressive symptoms and ART adherence. While the effect at 3-month follow up, the AiCare program showed a significant improvement for illness acceptance (β=3.651, 95% CI: 1.219-6.083) and anxiety (β=2.054, 95% CI: 0.573-3.535). Feedback regarding the AiCare program indictaed its acceptbility and feasibility.

Conclusions:

The AiCare program demonstrated promising effects in improving disease adaptation outcomes among PLWH, notably in enhancing quality of life, fostering acceptance of illness, and mitigating anxiety symptoms. These findings underscore the hybrid program's potential clinical utility to facilitate the adaptation of PLWH. Clinical Trial: Chinese Clinical Trial Registry ChiCTR2400087255; https://www.chictr.org.cn/bin/project/edit?pid=220729