Ha Toan, Shi Hui, Pham Bang Nguyen, Dsouza Aidan, Shrestha Roman, Kuchipudi Suresh V, Luu Hung N, Le Ngoan Tran, Schensul Stephen L
Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA.
Vanderbilt University Medical Center, Nashville, USA.
Int J Behav Med. 2024 Jul 29. doi: 10.1007/s12529-024-10310-5.
Tension (often times called "Tenshun" in Hindi) is a cultural expression used to convey feelings of distress and common mental disorders in India and among South Asia communities. This study compared the effectiveness of different intervention sequences in reducing tension among alcohol-consuming men living with HIV in India.
This secondary data analysis paper utilized data from a randomized trial study titled "Alcohol and Antiretroviral Therapy (ART) Adherence: Assessment, Intervention, and Modeling in India." The multilevel interventions, including individual counseling (IC), group intervention (GI), and collective advocacy (CA), were conducted sequentially over three cycles at three ART centers. Additionally, another ART center, serving as a pilot site, received all three interventions simultaneously in the final cycle. Participants completed surveys assessing demographic characteristics, tension, and other variables including HIV stigma, a 4-day ART adherence, HIV symptoms, and depressive symptoms at four time points: baseline, 9 months, 18 months, and 24 months. General linear mixed models were employed to assess the intervention effects on tension.
Out of 940 participants, 666 reported experiencing tension, including 54% reporting high tension. At site 1, the GI-CA-IC sequence resulted in a slope of -0.06, indicating that this sequence reduced tension from T1 to T4 compared to the control group (p < 0.01). Additionally, the pilot site where the intervention package was conducted simultaneously had a slope of -0.06, indicating that the intervention package also reduced tension compared to the control group (p < 0.01). Conversely, the CA-IC-GI sequence resulted in a slope of 0.07, indicating that this sequence resulted in significantly higher tension levels than the control group (p = 0.008) contrary to the expectation that the sequence would reduce tension.
This study contributes valuable insights on the issue of tension among alcohol-consuming men living with HIV. The significant reduction in tension observed at the site using the GI-CA-IC sequence, which began with a group intervention, underscores the importance of intervention order and the importance of group intervention within multilevel intervention programs for tension reduction. Further research is needed to validate these observations and broaden our understanding of effective tension management strategies among people living with HIV in diverse settings.
URL: clinicaltrials.gov.
NCT03746457.
紧张情绪（在印地语中常被称为“Tenshun”）是一种文化表达方式，用于传达印度及南亚社区中人们的苦恼情绪和常见精神障碍。本研究比较了不同干预顺序在减轻印度感染艾滋病毒的饮酒男性紧张情绪方面的效果。
本二次数据分析论文利用了一项名为“酒精与抗逆转录病毒疗法（ART）依从性：印度的评估、干预与建模”的随机试验研究中的数据。包括个体咨询（IC）、团体干预（GI）和集体倡导（CA）在内的多层次干预在三个抗逆转录病毒治疗中心分三个周期依次进行。此外，另一个作为试点的抗逆转录病毒治疗中心在最后一个周期同时接受了所有三种干预。参与者在四个时间点（基线、9个月、18个月和24个月）完成了评估人口统计学特征、紧张情绪以及其他变量（包括艾滋病毒污名、4天的抗逆转录病毒治疗依从性、艾滋病毒症状和抑郁症状）的调查。采用一般线性混合模型评估干预对紧张情绪的影响。
在940名参与者中，666人报告有紧张情绪，其中54%报告为高度紧张。在站点1，GI-CA-IC顺序导致斜率为-0.06，表明与对照组相比，该顺序从T1到T4减轻了紧张情绪（p < 0.01）。此外，同时实施干预套餐的试点站点斜率为-0.06，表明与对照组相比，该干预套餐也减轻了紧张情绪（p < 0.01）。相反，CA-IC-GI顺序导致斜率为0.07，表明该顺序导致紧张情绪水平显著高于对照组（p = 0.008），这与该顺序会减轻紧张情绪的预期相反。
本研究为感染艾滋病毒的饮酒男性的紧张情绪问题提供了有价值的见解。在以团体干预开始的使用GI-CA-IC顺序的站点观察到紧张情绪显著降低，这凸显了干预顺序的重要性以及团体干预在多层次干预项目中减轻紧张情绪方面的重要性。需要进一步研究来验证这些观察结果，并拓宽我们对不同环境下艾滋病毒感染者有效紧张情绪管理策略的理解。
网址：clinicaltrials.gov。
NCT03746457。
