Zelenev, Alexei and Huedo-Medina, Tania B. and Shrestha, Roman and Mistler, Colleen B. and Altice, Frederick L. and Sibilio, Brian and Copenhaver, Michael M. (2024) Comparing the brief Holistic Health for HIV (3H+) to the Holistic Health Recovery Program (HHRP plus ) among people with HIV and opioid use disorder: Results from a randomized, controlled non-inferiority trial. PLoS ONE, 19 (11). e0312165. ISSN 1932-6203, DOI https://doi.org/10.1371/journal.pone.0312165.
Full text not available from this repository.Abstract
Few evidence-based interventions have been widely adopted in common clinical settings, particularly for opioid-dependent people with HIV (PWH) seeking drug treatment. We developed a brief evidence-based intervention, Holistic Health for HIV (3H+), specifically for ease of implementation and integration within drug treatment settings. In this study, we compared 3H+ to the gold standard, Holistic Health Recovery Program (HHRP+) using a non-inferiority trial. Between 2012 and 2017, 106 participants were randomly assigned to either the brief 3H+ intervention or the gold standard HHRP+. HIV treatment (ART adherence, viral suppression) and risk behaviors (sharing injection equipment, condom use) were compared between the two arms at baseline, end-of-intervention (EOI-12 weeks) and at follow-up (24 weeks). Average treatment effect was calculated based on the difference-in-difference (DID) estimator and a non-parametric bootstrap was used to assess non-inferiority. At the 12-week EOI point, 3H+ was found to be non-inferior to HHRP+ with respect to multiple outcomes: percent sharing syringes and needles (DID:1.4, 95%CI -18.6,21.5], p<0.01) and attainment of high ART adherence (DID: 9.7, 95%CI: -13.1, 32.2], p = 0.04). At the 24-week EOI point, 3H+ was found to be non-inferior to HHRP+ with respect to percent sharing syringes and needles (DID: 8.9, -10.1, 28.30], p = 0.04) and attainment of viral suppression (DID: 18.9, 95% CI:-7.1, 42.0], p = 0.01). For other indicators, such as consistent condom use, the hypothesis test for non-inferiority was inconclusive at the 12-week EOI (DID: -20.2, 95%CI -48.9-10.7], p = 0.51). For HIV treatment as prevention to be effective, PWH need to achieve viral suppression. In the absence of this success, they must reduce HIV risk behaviors. The finding that 3H+ was non-inferior to HHRP+ suggests that brief behavioral interventions can be deployed in real world settings to help more efficiently achieve Ending the HIV Epidemic goals.
| Item Type: | Article |
|---|---|
| Funders: | United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute on Drug Abuse (NIDA) (R01 DA032290) ; (K01 DA051346) ; (K24 DA017072) ; (K24 DA051344), United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute of Mental Health (NIMH) (T32MH07438714) |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine Centre of Excellence for Research in AIDS (CERiA) |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 21 Feb 2025 02:53 |
| Last Modified: | 21 Feb 2025 02:53 |
| URI: | http://eprints.um.edu.my/id/eprint/47334 |
Actions (login required)
 |
View Item |
