China is facing an HIV/AIDS crisis. Although treatment, including free medication, is increasingly available, reports of nonadherence are already surfacing. Within the current window of opportunity, there is an urgent need for research for the development of adherence enhancement programs, which will bolster the efficacy of the medication regimens and thwart the development and transmission of drug resistant virus. The proposed R34 application in response to PAR-03-078 involves a 3-year developmental project to design and pilot a culturally appropriate, clinical feasible, and generalizable program. This project is a multidisciplinary collaboration among experienced investigators at the University of Washington, expert consultants across the U.S., researchers from China's CDC, and care providers at Ditan Hospital in Beijing. The primary aims of the project are to (1) Conduct qualitative research including in-depth interviews and focus groups with patients, their family and caretakers, and providers to determine common barriers and likely facilitators to antiretroviral adherence, which will further guide intervention development; (2) Design a culturally sensitive and theoretically driven adherence program suitable for the Chinese HIV-Positive population, including development of an intervention manual and training materials; (3) Pilot test the program on 10 patients; and (4) After adjustments based on findings from the pilot, implement a preliminary randomized controlled trial (RCT) of 60 patients with 2 arms (minimal vs. enhanced intervention) to assess feasibility and initial efficacy. Although the exact nature of the intervention will depend upon findings from the qualitative phase of the project, research from studies based in the West as well as preliminary work in country suggest the potential acceptability and usefulness of a comprehensive program involving such components as informational group meetings, one-on-one psycho-educational counseling with nurses, DOT provided by family members, alarm reminders, and peer support.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
5R34MH074364-02
Application #
7056653
Study Section
Special Emphasis Panel (ZMH1-ERB-C (04))
Program Officer
Stirratt, Michael J
Project Start
2005-04-20
Project End
2008-03-31
Budget Start
2006-04-01
Budget End
2007-03-31
Support Year
2
Fiscal Year
2006
Total Cost
$167,099
Indirect Cost
Name
University of Washington
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
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Chen, Wei-Ti; Shiu, Cheng-Shi; Simoni, Jane M et al. (2013) Challenges of cross-cultural research: lessons from a U.S.-Asia HIV collaboration. Nurs Outlook 61:145-52
Shiu, Cheng-Shi; Chen, Wei-Ti; Simoni, Jane et al. (2013) The Chinese Life-Steps Program: A Cultural Adaptation of a Cognitive-Behavioral Intervention to Enhance HIV Medication Adherence. Cogn Behav Pract 20:202-212
Chen, Wei-Ti; Lee, Shih-Yu; Shiu, Cheng-Shi et al. (2013) Fatigue and sleep disturbance in HIV-positive women: a qualitative and biomedical approach. J Clin Nurs 22:1262-9
Chen, Wei-Ti; Shiu, Cheng-Shi; Yang, Joyce P et al. (2013) Antiretroviral Therapy (ART) Side Effect Impacted on Quality of Life, and Depressive Symptomatology: A Mixed-Method Study. J AIDS Clin Res 4:218
Chen, Wei-Ti; Shiu, Cheng-Shi; Yang, Joyce P et al. (2013) Fatigue and Sleep Disturbance Related to Perceived Stress in Chinese HIV-Positive Individuals: A Mixed Methods Study. J AIDS Clin Res 4:
Rao, D; Chen, W T; Pearson, C R et al. (2012) Social support mediates the relationship between HIV stigma and depression/quality of life among people living with HIV in Beijing, China. Int J STD AIDS 23:481-4

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