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Randomized Controlled Trial of Rise, A Community-Based Culturally Congruent Counseling Intervention to Support

Laura M Bogart1, Matt G Mutchler2,3, Kathy Goggin4

  • 1RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA, 90407-2138, USA. lbogart@rand.org.

AIDS and Behavior
|November 18, 2022
PubMed

Insights

Culturally tailored interventions like Rise significantly improve antiretroviral therapy adherence for Black Americans with HIV. This community-based program also reduced HIV stigma and medical mistrust.

Area of Science:

  • Public Health
  • Health Disparities Research
  • Behavioral Science

Background:

  • Structural inequities contribute to HIV disparities, impacting adherence and viral suppression among Black Americans.
  • Low antiretroviral therapy (ART) adherence and viral suppression rates persist in this population.
  • Culturally congruent interventions are needed to address these health inequities.

Purpose of the Study:

  • To evaluate the effectiveness of the Rise intervention, a community-based, culturally congruent program, on ART adherence and viral suppression among Black adults living with HIV.
  • To assess the intervention's impact on HIV stigma, medical mistrust, and HIV-serostatus disclosure.
  • To determine the cost-effectiveness of the Rise intervention.

Main Methods:

  • A randomized controlled trial was conducted with 166 Black adults living with HIV in Los Angeles County.
  • The intervention group received culturally tailored adherence counseling and social determinants of health referrals.
  • Outcomes included electronically monitored adherence, HIV viral load, and survey data collected at baseline, 7, and 13 months.

Main Results:

  • The Rise intervention significantly increased adherence likelihood (two-fold) compared to the control group.
  • Participants in the Rise group showed significantly lower HIV stigmatizing beliefs and reduced medical mistrust.
  • No significant effects were observed on HIV viral suppression, internalized stigma, or disclosure.

Conclusions:

  • Culturally tailored interventions, such as Rise, are effective in improving ART adherence for Black Americans living with HIV.
  • The Rise intervention demonstrates potential for reducing HIV stigma and medical mistrust within this population.
  • Rise is a cost-effective intervention for improving adherence, with an estimated cost of $335 per 10% adherence increase.

Keywords:
AdherenceAntiretroviral therapyBlack/African AmericanHIVMotivational InterviewingRandomized controlled trial

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