A Mind-Body intervention to reduce symptoms among people aging with HIV (1 R34 AT009966-01) Project Summary Half of those infected with HIV in the United States are over 50 years of age; this is expected to increase to 70% by 2020. Yet, few interventions exist for older people living with HIV/AIDS that address psychological symptoms, and none that address physical symptoms, both of which are prevalent in this population. There is a need to find innovative and accessible interventions that can help older people living with HIV/AIDS to manage their symptoms. Mind-body interventions, like Tai chi and Qi gong (TCQ), improves both physical and psychological health. TCQ is a series of slow, low-impact meditative movements that integrates breath work, meditation, and stances. We propose the refinement, adaptation, acceptability and feasibility testing of a standardized TCQ intervention shown efficacious with cancer patients, to an ethnically diverse population of older people living with HIV/AIDS, with the goal of enhancing their ability to manage psychological and physical symptoms. Thus, this study proposes three aims: (i) to refine and culturally adapt a TCQ intervention protocol for a diverse sample of older people living with HIV/AIDS (50 years of age or older); (ii) to evaluate the acceptability of the TCQ intervention, a sham qigong control condition, and a standard of care control condition for older people living with HIV/AIDS (n = 60); and (iii) to evaluate the feasibility of the TCQ intervention and sham qigong control condition. Participants will be recruited from a federally qualified health center in Miami, Florida. Adaptation of the TCQ intervention, the first aim, will be done through qualitative research. An expert panel discussion, key informant interviews, and three focus groups will be conducted, and analyzed by thematically based content analysis. To address aims 2 and 3 we will conduct a pilot study; participants will be randomized to one of 3 conditions: the TCQ intervention, a sham qigong condition, or a standard of care condition. We will assess acceptability and feasibility through questionnaires and adherence to TCQ. Outcomes will be assessed at baseline, 2-week post-intervention, and at three months follow up. Analysis of outcomes will include meeting specific a prori benchmarks for feasibility and acceptability, ranging from 80% to 90%. In addition, assessment will include measurements based on both participants and trainers, such as use of the intervention fidelity checklist. This study addresses an important need for older people living with HIV/AIDS to acquire skills to self-manage both psychological and physical symptoms, both of which are prevalent in this population.
If found acceptable and feasible, the proposed intervention offers an easy way to address both HIV-related psychological and physical symptoms among older people living with HIV. It can improve the quality of life and health outcomes of older HIV+ individuals, the fastest growing segment of the HIV+ population in the U.S. Lastly, because symptoms predict medication adherence, it can indirectly promote adherence which in turn will keep individuals virally suppressed, making HIV transmission less likely.
