The Positive Outlook Study: A Randomised Controlled Trial Evaluating Online Self-Management for HIV Positive Gay Men

Tanya Millard; Paul A Agius; Karalyn McDonald; Sean Slavin; Sonya Girdler; Julian H Elliott

doi:10.1007/s10461-016-1301-5

The Positive Outlook Study: A Randomised Controlled Trial Evaluating Online Self-Management for HIV Positive Gay Men

AIDS Behav. 2016 Sep;20(9):1907-18. doi: 10.1007/s10461-016-1301-5.

Authors

Tanya Millard¹, Paul A Agius^{2

3}, Karalyn McDonald^{4

3

5

6}, Sean Slavin⁷, Sonya Girdler⁸, Julian H Elliott^{4

2

9}

Affiliations

¹ Department of Infectious Diseases, Monash University, Level 2 Burnet Tower, 85 Commercial Road, Melbourne, 3004, Australia. tanya.millard@monash.edu.
² Centre for Population Health, Burnet Institute, Melbourne, Australia.
³ Judith Lumley Centre, La Trobe University, Melbourne, Australia.
⁴ Department of Infectious Diseases, Monash University, Level 2 Burnet Tower, 85 Commercial Road, Melbourne, 3004, Australia.
⁵ Jean Hailes Research Unit, Monash University, Melbourne, Australia.
⁶ Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.
⁷ Centre for Social Research in Health, University of New South Wales, Sydney, Australia.
⁸ School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
⁹ Infectious Diseases Unit, Alfred Hospital, Melbourne, Australia.

PMID: 26896121
DOI: 10.1007/s10461-016-1301-5

Abstract

The aim of this paper was to evaluate the effectiveness of an online self-management program in improving health outcomes and well-being for gay men living with HIV in Australia. The online Positive Outlook Program was based on self-efficacy theory and used a self-management approach to enhance HIV-positive gay men's skills, confidence and abilities to manage the psychosocial issues associated with HIV in daily life. The 7-week program was delivered in closed groups and comprised information modules, action-planning activities, moderated discussion boards, and weekly peer-facilitated 'live chats'. A randomised controlled trial was conducted to establish the effectiveness of the Positive Outlook program compared to a 'usual care' control. Participants were HIV-positive gay men 18 years or older living in Australia. Primary outcomes were evaluated at three time-points (baseline, post-intervention and 12-week's post-intervention follow-up) and included HIV-related quality of life (PROQOL-HIV), outcomes of health education (HeiQ) and HIV specific self-efficacy (Positive Outlook Self-Efficacy Scale). A total of 132 gay men with HIV in Australia were randomly allocated to the intervention (n = 68) or usual care control (n = 64) groups. Maximum likelihood marginal-linear modelling indicated significant improvement in the intervention group on the PROQOL-HIV subscales of body change (p = 0.036), social relationships (p = 0.035) and emotional distress (p = 0.031); the HeiQ subscales of health-directed activity (p = 0.048); constructive attitudes and approaches (p = 0.015); skill and technique acquisition (p = 0.046) and health service navigation (p = 0.008); and the Positive Outlook Self-Efficacy Scale on the subscales of relationships (p = 0.019); social participation (p = 0.006); and emotions (p = 0.041). Online delivery of self-management programs is feasible and has the potential to improve quality of life, self-management skills and domain specific self-efficacy for gay men with HIV.

Keywords: HIV; Internet; Online; Positive Outlook Program; Quality of life; Randomised controlled trial; Self-management; Web-based.

Publication types

Randomized Controlled Trial

MeSH terms

Australia
HIV Infections / psychology*
HIV Infections / therapy
Humans
Internet
Male
Outcome and Process Assessment, Health Care
Peer Group
Program Evaluation
Quality of Life / psychology*
Self Care / methods
Self Care / psychology*
Self Efficacy
Sexual and Gender Minorities / psychology*