Integrating Cognitive Dysfunction Accommodation Strategies into an HIV Prevention Session: A 2-Arm Pilot Feasibility Study.

Cognitive dysfunction is prevalent among persons on medication for opioid use disorder (MOUD). This cognitive dysfunction has been shown to reduce HIV treatment engagement and medication adherence. We investigated the impact of integrating specific behavioral strategies into an HIV prevention session to accommodate cognitive dysfunction among people on MOUD. Patients on MOUD (n = 20) were randomized to one of two different HIV prevention conditions. The same HIV risk reduction content was presented to both conditions; however, the experimental condition had accommodation strategies integrated into the session. Participants completed a skills checklist at pre-, post-, and 2-week follow-up to examine the level of HIV risk reduction content learned and utilized over time. Participants in the experimental condition indicated high acceptability (95%) for the accommodation strategies. These participants also demonstrated greater improvement in the ability to properly clean a syringe, from pre- to post- (p < 0.02) and from pre- to follow-up (p < 0.02) when compared to participants in the standard condition. Results from this pilot study indicate that accommodation strategies improved participants’ ability to learn, retain, and utilize risk reduction skills over time. This foundation of research indicates a promising, innovative strategy to increase the ability for persons on MOUD to engage in HIV prevention behaviors.

认知功能障碍在因阿片类药物使用障碍而接受药物治疗（MOUD）的人群中普遍存在。这种认知功能障碍已被证明会降低艾滋病治疗的参与度和药物依从性。我们研究了将特定的行为策略整合到艾滋病预防课程中以适应接受MOUD治疗者的认知功能障碍所产生的影响。20名接受MOUD治疗的患者被随机分配到两种不同的艾滋病预防条件中的一种。两种条件下呈现的艾滋病风险降低内容相同；然而，实验组在课程中整合了适应性策略。参与者在干预前、干预后以及2周随访时完成一项技能清单，以检查随着时间推移所学习和运用的艾滋病风险降低内容的水平。实验组的参与者对适应性策略表示出较高的接受度（95%）。与标准组的参与者相比，这些参与者在正确清洁注射器的能力方面也表现出更大的提高，从干预前到干预后（p < 0.02）以及从干预前到随访（p < 0.02）均是如此。这项试点研究的结果表明，适应性策略提高了参与者随着时间推移学习、保留和运用风险降低技能的能力。这项研究基础表明了一种有前景的创新策略，可提高接受MOUD治疗者参与艾滋病预防行为的能力。