Engaging African Americans Living with HIV and Serious Mental Illness: Piloting Prepare2Thrive-A Peer-Led Intervention.

ABSTRACT

BACKGROUND: African American individuals living with HIV (AALWH) and serious mental illness (SMI) represent a vulnerable intersectional group with relatively poor health. These individuals may require consistent treatment engagement to manage both of their chronic conditions; however, due to multilevel factors they are relatively less likely to engage in treatment consistently. OBJECTIVES: To test the acceptability, feasibility, fidelity, and participant outcomes of a brief psychoeducational and behavioral peer-led intervention. METHODS: Participants engaged in four weekly 90-minute pilot intervention sessions developed by the current community-based participatory research (CBPR) team. Sessions focused on problem-solving, communication skills, and coping with stigma, and were delivered by CBPR peerinterventionists. Participants completed pre- and postintervention surveys assessing treatment engagement and self-efficacy. RESULTS: Participants (N = 16) rated the intervention as acceptable, and attendance rates were high (87% average). Intervention leaders demonstrated exceptionally high fidelity to the intervention protocol. Participants reported a trend toward increasing antiretroviral therapy (ART) adherence from pre- to post-intervention (on average, an 8% increase, p = 0.063), notable in the context of a pilot study. Those who attended all four intervention sessions reported a 17.5% increase in ART adherence. From pre- to post-intervention medical appointment attendance decreased, mental health appointment attendance increased, and HIV treatment selfefficacy significantly increased. CONCLUSIONS: This study provides initial evidence for the feasibility of a CBPR-designed and tested, peer-led psychoeducation and behavioral intervention aiming to improve treatment engagement among AALWH and SMI, a marginalized group who could benefit from additional communitybased health research efforts.