Randomized clinical trial of a community navigation intervention to improve well-being in persons living with HIV and other co-morbidities

AIDS Care. 2019 May;31(5):529-535. doi: 10.1080/09540121.2018.1546819. Epub 2018 Nov 15.

Abstract

Long-term survival of people living with HIV (PLWH) is associated with the development of co-morbid conditions and need for symptom management and other efforts to enhance quality of life. We conducted a longitudinal, randomized trial over 36 months to evaluate the effect of a community-based navigator intervention to provide early palliative care to 179 PLWH and other chronic conditions. Outcomes included quality of life, symptom management, coping ability, social support, self-management, and completion of advance directives. Data were analyzed using SAS mixed effects model repeat measurement. Our navigator program showed variable improvement over time of three outcome variables, self-blame, symptom distress, and HIV self-management. However, the program did not improve overall quality of life, social support, or completion of advance directives.

Keywords: HIV/AIDS; community-based health care; multimorbidity; palliative care; symptom management.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Chronic Disease / epidemiology
  • Chronic Disease / therapy
  • Community-Based Participatory Research
  • Comorbidity
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / psychology
  • HIV Infections / therapy*
  • Humans
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Palliative Care / methods
  • Palliative Care / organization & administration*
  • Patient Navigation*
  • Quality of Life*
  • Self-Management
  • Social Support*