In Vietnam, adolescent and young men who have sex with men (AYMSM) are among those most affected by HIV, and they also experience significant HIV-related mental health and stigma challenges. The study team proposes to adapt Project YES+ to address both mental health and internalized HIV stigma among AYMSM living with HIV in Vietnam. This research will build local capacity and develop networks for collaborative research on mental health and stigma in this population between Vietnam, Zambia and the United States.
The specific aims of this proposal are to (1) adapt Project YES+ to create To-Hieu (I understand) to improve mental health and internalized HIV stigma for AYMSM living with HIV in Vietnam and (2) examine acceptability and feasibility of To-Hieu among AYMSM living with HIV in Vietnam through a pilot randomized controlled trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
80
Project YES+ was developed from two evidence-based interventions - Project Yes! and Self-Help Plus, based on Social Cognitive Theory (Project Yes!) and Acceptance and Commitment Therapy (Self-Help Plus). The youth-focused intervention component comprises 6 individual sessions with a youth peer mentor, 3 youth group sessions facilitated by a youth peer mentor and 5 group sessions to learn stress management skills. The original intervention was designed for 4 months and involves caregivers. The adaptation of Project YES+ for adolescents and young men who have sex with men living with HIV in Vietnam will make revisions on the content, frequency and delivery format of the intervention.
Hanoi Medical University
Hanoi, Hanoi, Vietnam
Acceptability: Client satisfaction
Scores on the Client Satisfaction Questionnaire (CSQ-8). Total scores range from 8 to 32, with the higher number indicating greater satisfaction.
Time frame: At the end of the intervention at 4 months.
Feasibility: intervention attendance
Percentage of participants who complete at least 80% of the required sessions of To-Hieu
Time frame: From enrollment to the end of the intervention at 4 months
Acceptability: perception of implementation
Acceptability will be assessed qualitatively with exit interviews with AYMSMLH and youth peer mentors
Time frame: At the end of the intervention at 4 months.
Feasibility: Perception of implementation
Feasibility will be assessed qualitatively in exit interviews with AYMSMLH and youth peer mentors.
Time frame: At the end of the intervention at 4 months
Preliminary effectiveness: changes in mental health symptom severity
Depression and anxiety symptoms over the past two weeks will be assessed using the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder (GAD-7) questionnaire. PHQ-9 scores range from 0 to 27 and GAD-7 scores range from 0 to 21, with higher scores indicate greater symptom severity.
Time frame: Baseline and at the end of the intervention at 4 months
Preliminary effectiveness: Change in percentage of ART adherence
ART adherence will be assessed as the percentage of prescribed doses taken over the past 4 days, calculated using the self-reported number of missed doses and the total number of prescribed doses during that period.
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Time frame: Baseline and at the end of the intervention at 4 months
Preliminary effectiveness: HIV viral load
HIV viral load will be assessed with a test provided by the study or through participants' medical records (if available)
Time frame: Baseline and at the end of the intervention at 4 months
Preliminary effectiveness: changes in internalized HIV stigma scores
Changes in internalized HIV stigma scores will be measured using the 6-item Internalized AIDS-Related Stigma Scale. Scores range from 6 to 24, with higher scores indicate greater internalized stigma.
Time frame: Baseline and at the end of the intervention at 4 months
Preliminary effectiveness: changes in sexual minority stigma
Changes in sexual minority stigma will be assessed using the 7-item, 3-factor Reactions to Homosexuality Scale. Total scores range from 7 to 49, with higher scores indicate lower levels of internalized stigma.
Time frame: Baseline and at the end of the intervention at 4 months