Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, Chapel Hill, 450 West Dr, NC, 27599, USA.
School of Public Health, and Philosophy, Rutgers University Institute for Health, 112 Paterson St, NJ, 08901, USA.
AIDS Res Ther. 2024 Aug 6;21(1):51. doi: 10.1186/s12981-024-00640-5.
In the US, 1.2 million people live with HIV (PWH). Despite having near-normal life expectancies due to antiretroviral therapy (ART), many PWH seek an HIV cure, even if it means risking their lives. This willingness to take risks for a cure raises questions about "affective forecasting biases," where people tend to overestimate the positive impact of future events on their well-being. We conducted a study to test two interventions to mitigate affective forecasting in the decisions of PWH about taking HIV cure medication.
We recruited PWH to complete a 30-minute survey about their current quality of life (QoL) and the QoL they anticipate after being cured of HIV, and assigned them to either no additional intervention, to one of two interventions intended to reduce affective forecasting bias, or to both interventions: (1) a defocusing intervention designed to broaden the number of life domains people consider when imagining life changes associated with new circumstances (e.g. HIV cure); and (2) an adaptation intervention to help them gauge fading of strong emotions over time. The study design included a 2 × 2 design: defocusing (yes/no) x adaptation (yes/no) intervention. We assessed PWH's willingness to take hypothetical HIV sterilizing cure medication using the Time Trade-Off (TTO) and their quality of life predictions with WHOQOL-HIV.
296 PWH participated. Counter to what we had hypothesized, neither intervention significantly reduced PWH's willingness to trade time for a cure. Instead, the defocusing intervention increased their willingness to trade time (IRR 1.77, p = 0.03). Exploratory analysis revealed that PWH with lower current quality of life who received the defocusing intervention were more willing to trade time for a cure.
These negative findings suggest that either these biases are difficult to overcome in the settings of HIV curative medication or other factors beyond affective forecasting biases influence willingness to participate in HIV curative studies, such as respondents' current quality of life.
在美国，有 120 万人感染了 HIV（HIV 感染者）。尽管由于抗逆转录病毒疗法（ART），他们的预期寿命接近正常，但许多 HIV 感染者寻求 HIV 治愈方法，即使这意味着要冒生命危险。这种为治愈而冒险的意愿引发了关于“情感预测偏差”的问题，即人们倾向于高估未来事件对其幸福感的积极影响。我们进行了一项研究，以测试两种干预措施来减轻 HIV 感染者在决定接受 HIV 治愈药物时的情感预测偏差。
我们招募了 HIV 感染者完成一项 30 分钟的调查，内容涉及他们目前的生活质量（QoL）和他们预期在 HIV 治愈后的生活质量，并将他们分配到以下三组之一：（1）不进行任何额外干预；（2）接受两种旨在减轻情感预测偏差的干预措施之一或两种干预措施：（1） 分散注意力干预，旨在拓宽人们在想象与新情况相关的生活变化时考虑的生活领域数量（例如 HIV 治愈）；（2） 适应干预，帮助他们衡量随着时间的推移强烈情绪的淡化。研究设计包括 2×2 设计：分散注意力（是/否）x 适应（是/否）干预。我们使用时间交换（TTO）评估 HIV 感染者接受假设性 HIV 绝育治愈药物的意愿，并使用 WHOQOL-HIV 评估他们的生活质量预测。
共有 296 名 HIV 感染者参与。与我们的假设相反，两种干预措施都没有显著降低 HIV 感染者为治愈而交换时间的意愿。相反，分散注意力干预增加了他们交换时间的意愿（IRR 1.77，p=0.03）。探索性分析表明，接受分散注意力干预的当前生活质量较低的 HIV 感染者更愿意用时间换取治愈。
这些负面发现表明，在 HIV 治愈药物的情况下，这些偏差要么难以克服，要么除了情感预测偏差之外，还有其他因素影响愿意参与 HIV 治愈研究，例如受访者的当前生活质量。
