Abstract #336  -  An Intervention to Improve Quality of Life for People Living with HIV in Thailand
Authors:   Presenting Author:   Dr. Li Li - UCLA
Additional Authors:  Dr.  Sung-Jae Lee, Dr. Chuleeporn Jiraphongsa, Dr. Mary Jane  Rotheram-Borus,
Aim: People living with HIV (PLH) in Thailand face multiple stressors, including as disclosure, stigma, and maintaining health, mental health and positive family relationships. There are limited interventions tailored to PLH in Thailand. This study presents findings from a randomized controlled intervention trial with its newly available 12-month follow-up data.
Method / Issue: The proposed study builds on the previous work with PLH in the U.S., China, and South Africa. The intervention was adapted to tailor the contents and sessions to meet the needs of PLH in Thailand. The intervention contained four modules consisting of 13 sessions delivered over 13 weeks. The four modules covered the following areas: 1) healthy mind; 2) healthy body; 3) healthy family relationships; and 4) social and community integration. From January 2007 to February 2008, 507 PLH were recruited to the intervention trial from four district hospitals in Northern (Chiang Rai) and Northeastern (Korat) Thailand. Within each district hospital, PLH were randomized to either the intervention group (n=260) or the standard care group (n=247). To evaluate the efficacy of the intervention, trained interviewers administered Computer Assisted Personal Interviews (CAPI) to PLH at baseline, 6 and 12-month period. The main outcome of interest was PLH¡¯s quality of life, measured by the Medical Outcomes Study HIV (MOS-HIV) subscales addressing general health, mental health and physical health. The efficacy of the intervention was assessed by estimating mixed-effects models to fit PLH quality of life outcomes to the intervention being the main independent variable of interest. Based on the correlational analysis performed at baseline, variables included in the final models were age, gender, years since diagnosis, HIV disclosure, stigma, social support, and family functioning. The retention rate of PLH over 12 months was over 96%.
Results / Comments: At baseline, the characteristics of PLH in the intervention and the standard care group were comparable, indicating that the randomization resulted in well-balanced groups. The mixed effects models assessing the effect on the intervention on PLH¡¯s general health revealed that PLH in the intervention group reported significant improvement in their general health over 12 months, compared to PLH in the standard care group (B= 2.00, p=0.004). Similarly, we found a significant improvement in mental health among PLH in the intervention group over 12 months (B= 1.46, p=0.04), compared to PLH in the standard care group. PLH in the intervention group also reported improvements in their physical health; however, this effect was not statistically significant (p=0.16).
Discussion: Our findings demonstrated a successful efficacy of an intervention designed to improve the quality of life of PLH in Thailand. Our intervention was developed in collaboration with the local teams. Mounting an effective intervention needs to be performed in a systematic, collaborative manner to ensure the success, cultural relevance, and sustainability. Building on the success of the current intervention trial, we are continuing the follow-up of PLH for additional 12 months to examine whether the intervention effect is sustainable over 24 months.
Go Back