Fatigue management for adults living with HIV: A randomized controlled pilot study

Fatigue is a prevalent symptom for adults living with HIV infection. The purpose of this randomized clinical trial was to pilot test a behavioral-educational intervention to reduce fatigue. The intervention included education about daytime behaviors as well as nighttime sleep behaviors. Participants were HIV-positive, between 45 and 75 years old, unemployed, and experiencing fatigue. They were randomized to intervention (n = 25) or control (n = 26) after obtaining baseline measures, administered the intervention or attention control, and followed with monthly assessments for 3 months. Primary outcome measures included the Fatigue Severity Scale (FSS) and fatigue symptom burden using the four-dimension structure of the Memorial Symptom Assessment Scale that includes occurrence, frequency, severity, and distress of a symptom. Other measures included the International Physical Activity Questionnaire, step counts with a Fitbit Flex, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, and Sleep Behavior Rating Scale. Compared with attention controls, the intervention group had significantly (p < .05) lower FSS scores and fatigue symptom burden over time, particularly in the frequency dimension. Secondary outcomes for reducing daytime naps and improving sleep quality were also significant (p < .05). This intervention, focused on both daytime and nighttime behaviors, demonstrated promising effects for reducing fatigue among adults living with HIV. Results provide useful direction for larger clinical trials to reduce fatigue in adults living with other types of chronic illness.