ACT on Health Lab

THRIVE - Targeting HIV Retention and Improved Viral Load Through Engagement


The overall aim of this project is to develop an effective intervention that will lead out-of-care persons with HIV to re-engage in HIV treatment and self-care.

Background Information

  • Retention in care and viral load suppression remain a challenge for many persons with HIV (PWH), who often turn to maladaptive avoidant coping strategies to deal with stigma, depression, anxiety, and other uncomfortable experiences.
  • Unfortunately, these strategies can keep PWH out of care and exacerbate or maintain the stigma and mental health difficulties that are common in PWH.
  • Acceptance and Commitment Therapy (ACT) is well-suited to help out-of-care PWH overcome the cycle of avoidance by promoting acceptance and engagement in valued-life activities.
  • Finding PWH who are out of care is difficult, but hospitalization is relatively common in PWH and presents an opportunity to re-engage PWH in outpatient care.
  • For out-of-care persons with unsuppressed viral load (VL), re-engagement in care is necessary to improve health. No existing interventions are efficacious for the out-of-care PWH found outside the HIV clinic.

This project will:

  • Adapt an Acceptance and Commitment Therapy (ACT) intervention for use with hospitalized, out-of-care persons living with HIV (PWH)
  • Pilot the intervention with 10 hospitalized PWH
  • Refine the intervention based on feedback from the 10 PWH
  • Test the refined ACT intervention, compared to Usual Care, in an RCT of 70 PWH. Feasibility and acceptability are the primary outcomes of interest. We will also assess preliminary effects on VL and retention in care.

Study Specifications

  • Sample Size for Step 2:  N=10 over six months 
  • Sample Size for Step 4:  N= 70 over two years
  • Recruiting ~ Ten participants each month
  • Treatment groups: ACT plus Education (ACT) or Treatment as Usual (TAU)