Developing a Resilience Intervention for Older, HIV-Infected Women

为感染艾滋病毒的老年妇女制定复原力干预措施

• 批准号: 9269797
• 负责人: Christina Psaros
• 金额: $ 23.23万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9269797
• 关键词: AIDS/HIV problem; Acute; Adherence; Age; Aging; Anxiety; Area; Behavioral; Blood Pressure; Caring; Chronic Disease; Chronic stress; Clinical; Cognitive; Complex; Control Groups; Data; Disease; Distress; Elderly; Elements; Event; Fatigue; Feasibility Studies; Feedback; Fibrinogen; Fostering; General Hospitals; Goals; HIV; HIV diagnosis; Headache; Health; Health Status; Illness impact; Immunity; Individual; Institutes; Intervention; Intervention Studies; Interview; Lead; Length; Life; Longevity; Massachusetts; Measures; Mediation; Medical; Mental Depression; Mental Health; Mind; Mind-Body Intervention; Outcome; Participant; Patients; Pharmaceutical Preparations; Phase; Pilot Projects; Population; Procedures; Protocols documentation; Psychology; Quality of life; Randomized; Reporting; Research; Risk; Sleep; Social isolation; Social support; Stress; Symptoms; Testing; United States; Viral Load result; Woman; Work; age related; antiretroviral therapy; base; biopsychosocial; body-mind; chronic pain; depressive symptoms; experience; group intervention; health related quality of life; healthy sexuality; improved; interest; intervention effect; male; men; mortality; older women; physical conditioning; psychologic; psychosocial; reduce symptoms; resilience; secondary outcome; skills; social stigma; stress management; stressor

Abstract HIV is no longer an acutely fatal disease. In fact, individuals living with HIV in the U.S. can now expect to live close to a normal lifespan with ongoing medical care. As a result, the population of individuals in the U.S. living with HIV is aging. Older, HIV-infected women are at risk for worse health outcomes than men. For example, older HIV-infected women experience greater levels of chronic pain and fatigue than their male counterparts, report lower levels of health related quality of life than men, and experience greater numbers of HIV-related health events and greater mortality than men. With respect to psychological and behavioral challenges, older HIV-infected women experience high rates of depression, challenges negotiating healthy sexuality, social isolation, stigma, and reduced adherence to antiretroviral therapy. Stress can worsen or perpetuate chronic illnesses, such as HIV. Few interventions to manage the stress of managing a life threatening illness have been developed for older adults with HIV; none focus on women, nor do existing interventions use a “strengths based” approach, such as developing skills that lead to greater resilience. To lay the groundwork for this work, we collected formative, qualitative data from HIV-infected women over 50 on the experience of aging as a woman with HIV in order to understand stressors and needs unique to this population. These data highlighted ways in which older women can be resilient in the face of HIV. Our colleagues at the Benson-Henry Institute for Mind-Body Medicine at Massachusetts General Hospital have developed a mind-body medicine resiliency intervention (“3RP intervention”) based on over 40 years of clinical work and research that has shown to decrease medical symptoms (overall, blood pressure, headaches, improved sleep, medication reduction), anxiety, distress, and stress among a variety of medical populations. The goal of this application is to refine and tailor the 3RP intervention to meet the specific needs of older, HIV-infected women and to complete a pilot study that will yield information on the acceptability and feasibility of studying the intervention in this group of patients. We will investigate the acceptability and feasibility in two phases. After we refine the intervention, we will test the intervention among two small groups of older, HIV-infected women. After we make any necessary changes, we will then conduct a small randomized pilot in which participants are randomized to the revised 3RP intervention or a control group. The data from this study will inform a larger study to further test the effect of the intervention and to investigate how to best deliver it so it can benefit as many older, HIV-infected women as possible.

抽象的 艾滋病毒不再是急性致命疾病。实际上，现在在美国享有艾滋病毒的人现在可以期望生活 接近正常的寿命，并持续医疗。结果，美国的个人人口生活 艾滋病毒正在衰老。艾滋病毒感染的妇女年龄较大，患有比男性更糟糕的健康状况的风险。例如， 与男性相比 报告与男性相关的健康质量质量较低，并经历更多与HIV有关 健康事件比男性更大。关于心理和行为挑战，年龄较大 艾滋病毒感染的妇女经历了高抑郁率，挑战就健康性，社会性谈判 分离，污名和降低抗逆转录病毒疗法的依从性。压力可能会担心或永久慢性 疾病，例如艾滋病毒。很少有干预措施管理管理威胁生命疾病的压力 是为艾滋病毒的老年人开发的；没有关注女性，也没有现有干预措施使用“优势 基于”的方法，例如发展能够提高韧性的技能。为这项工作奠定基础， 我们从50岁以上的艾滋病毒感染妇女中收集了形成性的定性数据，以衰老的经验 患有艾滋病毒的妇女，以了解压力源和需求对这一人群独有的需求。这些数据突出显示 面对艾滋病毒，老年妇女可以具有韧性的方式。我们在本森·亨利研究所的同事 马萨诸塞州综合医院的心身医学已经发展 基于已有40多年的临床工作和研究的干预（“ 3RP干预”）已显示 减轻医疗症状（总体，血压，头痛，改善睡眠，降低药物）， 各种医学人群中的焦虑，困扰和压力。该应用的目的是完善 并量身定制3RP干预措施，以满足感染了艾滋病毒的年龄较大的妇女的特定需求并完成飞行员 研究将产生有关研究这一组干预的可接受性和可行性的信息 患者。我们将研究两个阶段的可接受性和可行性。在我们完善干预后，我们 将测试两组年龄较大的HIV感染妇女的干预措施。在我们做任何必要之后 更改，然后我们将进行一个小的随机飞行员，其中参与者被随机分配到修订后 3RP干预或对照组。这项研究的数据将告知一项更大的研究，以进一步测试效果 干预措施并调查如何最好地交付它，以使其受益于许多年龄较大的艾滋病毒的妇女 尽可能。