Pilot Randomized Controlled Trial of an Intervention to Improve Coping with Intersectional Stigma and Medication Adherence Among HIV-Positive Latinx Sexual Minority Men

Abstract

We developed and pilot-tested an eight-session community-based cognitive behavior therapy group intervention to improve coping with intersectional stigma, address medical mistrust, and improve antiretroviral treatment adherence. Seventy-six HIV-positive Latinx sexual minority men (SMM; 38 intervention, 38 wait-list control) completed surveys at baseline, and 4- and 7-months post-baseline. Adherence was electronically monitored. Intention-to-treat, repeated-measures regressions showed improved adherence in the intervention vs. control group from baseline to follow-up [electronically monitored: b (95% CI) 9.24 (- 0.55, 19.03), p = 0.06; self-reported: b (95% CI) 4.50 (0.70, 8.30), p = .02]. Intervention participants showed marginally decreased negative religious coping beliefs in response to stigma [b (95% CI) = - 0.18 (- 0.37, 0.01), p = .06], and significantly lower medical mistrust [b (95% CI) = - 0.47 (- 0.84, - 0.09), p = .02]. Our intervention holds promise for improving HIV outcomes by empowering Latinx SMM to leverage innate resilience resources when faced with stigma.ClinicalTrials.gov ID (TRN): NCT03432819, 01/31/2018.

Keywords: Coping; HIV; Latinx; Sexual minority men; Stigma/discrimination.

Conflict of interest statement

Conflict of Interest: The authors declare that they have no conflict of interest.

Figures

Figure I

CONSORT Diagram of Participant Flow in the Siempre Seguiré Intervention Test

Figure II

Electronically Monitored Adherence Over Time (in Months) by Study Arm Note. Squares on the lines designate the preintervention period, circles the intervention period, and triangles the post-intervention period. Repeated-measures regression for intervention vs. control difference in the post-intervention period: b (95% CI) = 9.24 (−0.55, 19.03), p = 0.06 (Cohen’s effect size d = .44). Regression results and average adherence are weighted to account for presence of data at each month, among those with data at 0–1 month.