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 艾滋病毒不再是一种严重致命的疾病。事实上，美国艾滋病毒感染者现在可以预期存活。 在持续的医疗护理下，美国的人口接近正常寿命。 感染艾滋病毒的老年女性面临着比男性更糟糕的健康风险。 感染艾滋病毒的老年女性比男性腿部经历更严重的慢性疼痛和疲劳， 据报告，与健康相关的生活质量水平低于男性，并且与艾滋病毒相关的人数较多 就心理和行为挑战而言，老年人的健康事件和死亡率更高。 感染艾滋病毒的女性抑郁症发病率很高，在健康性行为、社交方面面临挑战 孤立、耻辱和抗逆转录病毒治疗依从性降低可能会使慢性病恶化或长期存在。 很少有干预措施可以控制危及生命的疾病带来的压力。 是为感染艾滋病毒的老年人制定的；没有一个以女性为重点，现有的干预措施也没有利用“优势” 基于”的方法，例如培养能够增强复原力的技能，为这项工作奠定基础， 我们从 50 岁以上感染艾滋病毒的女性那里收集了关于老龄化经历的形成性定性数据 这些数据强调了感染艾滋病毒的女性，以了解该人群特有的压力源和需求。 我们本森-亨利研究所的同事们如何帮助老年妇女在面对艾滋病毒时保持韧性。 马萨诸塞州总医院的身心医学已发展出身心医学弹性 干预（“3RP 干预”）基于 40 多年的临床工作和研究，已被证明可以 减少医疗症状（总体而言，血压、头痛、改善睡眠、减少药物治疗）， 该应用程序的目标是改善各种医疗人群的焦虑、痛苦和压力。 定制 3RP 干预措施，以满足感染艾滋病毒的老年妇女的具体需求，并完成试点 该研究将提供有关研究该组干预措施的可接受性和可行性的信息 在完善干预措施后，我们将分两个阶段调查患者的可接受性和可行性。 在我们采取必要措施后，将在两小组老年感染艾滋病毒的妇女中测试干预措施。 变化，然后我们将进行一个小型随机试点，其中随机化到修订后的 3RP 干预或对照组的数据将为更大规模的研究提供信息，以进一步测试其效果。 的干预措施，并研究如何最好地实施干预措施，以便使许多老年艾滋病毒感染妇女受益 尽可能。