Fazeli Pariya L, Vance David E, Delgadillo Jeremy D, Haase Shakaye R, Lambert Crystal Chapman, Bradley Brittany L, Azuero Andres, Turan Bulent, Kempf Mirjam Colette
School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
Nursing (Auckl). 2025;15:151-163. doi: 10.2147/nrr.s538597. Epub 2025 Aug 27.
Despite evidence that: 1) older people living with HIV (PLHIV) experience a high burden of stress that is associated with myriad poorer outcomes, 2) psychological resilience may buffer the negative effects of stress in older PLHIV, and 3) older PLHIV may possess lower levels of this protective factor than seronegative counterparts, little work has examined strategies to bolster resilience in older PLHIV. This article details the protocol for a pilot clinical trial examining the feasibility and efficacy of a theory-driven resilience intervention that has been adapted for older PLHIV.
This study plans to randomize 100 older PLHIV aged 45+ with suboptimal HIV treatment management to either an intervention condition (i.e., Resilience Intervention for Successful Aging Enhancement [RISE+]) or an attention-matched control condition. Both arms include weekly one-hour in person group intervention sessions. The comprehensive assessment includes proximal mechanistic measures, (i.e., real-time measurement of resilience resources and stress reactivity and recovery via experience sampling method [ESM] text message-prompted online surveys) and health (i.e., psychological functioning and HIV outcomes) measures. Primary Aims focus on intervention effects on: the use of resilience resources and whether such increases drive improved affective stress reactivity and recovery (Aim 1) and distal health outcomes at three months (Aim 2).
This study tests a novel resilience intervention among older PLHIV and has several strengths, including focusing on an at-risk and understudied population, rigorous examination of efficacy and mechanism, and utilizing an intervention with minimal facilitator involvement, which has implications for future scalability. Findings will identify intervention mechanisms and inform the development of potent and scalable interventions for building resilience in older PLHIV and other diverse populations of older adults.
尽管有证据表明：1）老年艾滋病毒感染者（PLHIV）承受着沉重的压力负担，这与众多较差的结果相关；2）心理韧性可能缓冲老年PLHIV压力的负面影响；3）老年PLHIV可能比血清阴性同龄人拥有更低水平的这种保护因素，但很少有研究探讨增强老年PLHIV韧性的策略。本文详细介绍了一项试点临床试验的方案，该试验旨在检验一种针对老年PLHIV改编的、基于理论的韧性干预措施的可行性和有效性。
本研究计划将100名年龄在45岁及以上、HIV治疗管理欠佳的老年PLHIV随机分为干预组（即成功衰老增强韧性干预[RISE+]）或注意力匹配对照组。两组均包括每周一次、每次一小时的面对面小组干预课程。综合评估包括近端机制测量（即通过经验抽样法[ESM]短信提示在线调查实时测量韧性资源、应激反应性和恢复情况）和健康测量（即心理功能和HIV相关结果）。主要目标集中在干预对以下方面的影响：韧性资源利用情况以及这种增加是否能推动改善情感应激反应性和恢复（目标1），以及三个月时的远端健康结果（目标2）。
本研究在老年PLHIV中测试了一种新型韧性干预措施，具有几个优点，包括关注高危且研究不足的人群、严格检验疗效和机制，以及使用一种对促进者参与要求极低的干预措施，这对未来的可扩展性具有重要意义。研究结果将确定干预机制，并为开发有效且可扩展的干预措施提供信息，以增强老年PLHIV及其他不同老年人群体的韧性。
