Family-Focused HIV Disclosure Intervention in Thailand

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DESCRIPTION (provided by applicant): This is a proposal for a Mentored Research Scientist Development Award. It is the investigator's long-term goal is to be a research leader who works closely with the community to design and implement behavioral interventions for HIV-affected families. HIV disclosure is a key stressor among HIV-affected families in Thailand, and the impact radiates throughout the family. By addressing HIV disclosure as a family matter, the proposed study aims to apply the Integrative Model of HIV Disclosure Decision Making in order to develop and pilot a culturally tailored intervention in Northeastern Thailand that is a combination of group sessions and home-based activities. To ensure the feasibility and sustainability, the proposed intervention will be designed to be integrated within the existing health care infrastructure of the district hospitals in Northeastern Thailand selected for the proposed study. The training goals of the proposed study are: 1. To gain expertise in qualitative research methodology, especially in-depth interviewing and focus group techniques used in behavioral intervention research. 2. To gain expertise in behavioral intervention design, with focus on family-focused interventions. 3. To gain additional expertise in quantitative research methodology, particularly on multi-level repeated measures analysis. Upon completion of the training goals, the specific aims of the proposed study are: 1. To explore the concerns, barriers and motivators within cultural attitudes and contextual factors around HIV disclosure from the perspectives of PLH, family members, and service providers (Phase 1). 2. To develop a family-focused intervention focusing on HIV disclosure (Phase 2), based on the findings from Phase 1. 3. To pilot test and assess the impact of the intervention on HIV disclosure, and social, physical, mental health, and behavioral outcomes (Phase 3). PUBLIC HEALTH RELEVANCE: The proposed study will be conducted in collaboration with the Thai Ministry of Public Health and the local district hospital teams in Northeastern Thailand. The overall goal of the proposed study is to develop and pilot an intervention for PLH to help them make thoughtful, well-informed decisions about HIV disclosure to their family members. The proposed intervention will improve the adjustment of PLH and their families.