Randomized controlled trial of a positive affect intervention to reduce stress in people newly diagnosed with HIV; protocol and design for the IRISS study

Abstract

Judith Tedlie Moskowitz,1 Adam W Carrico,2 Michael A Cohn,3 Larissa G Duncan,4 Cori Bussolari,5 Kristin Layous,6 Jen R Hult,7 Alex Brousset,8 Paul Cotton,3 Stephanie Maurer,3 Martha E Pietrucha,3 Michael Acree,3 Judith Wrubel,3 Mallory O Johnson,9 Frederick M Hecht,3 Susan Folkman9,10 1Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Evanston, IL, 2Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, 3Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA, 4Department of Family and Community Medicine, Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA, 5Department of Counseling Psychology, School of Education, University of San Francisco, San Francisco, CA, 6Department of Psychology, University of California Riverside, Riverside, CA, 7Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, 8Center for HIV Education Studies and Training, City University of New York, New York, NY, 9Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA, 10Department of Medicine, University of California San Francisco, San Francisco, CA, USA Abstract: Increasing evidence suggests that positive affect plays an important role in adaptation to chronic illness, independent of levels of negative affects like depression. Positive affect may be especially beneficial for people in the midst of severe stress, such as the diagnosis of human immunodeficiency virus (HIV). As medical treatments for HIV have improved, the number of people living with HIV has increased, and prevention strategies tailored specifically to people living with HIV have become a priority. There is a need for effective, creative, client-centered interventions that can be easily disseminated to community treatment settings, but there are currently few established interventions for people who are newly diagnosed with HIV. We present the design and methods for a randomized trial in which we test the efficacy of one such skills-based intervention that targets positive affect as a novel mechanism of change. The proposed research builds on observational findings of the important unique functions of positive affect. We aim to determine whether a five-session theory- and evidence-based intervention designed to teach skills for increasing the frequency and intensity of daily positive affect does so, and whether this intervention has beneficial effects on subsequent psychological well-being, health behaviors, and physical health up to 15 months after diagnosis with HIV. This is a randomized controlled trial in a sample of adults recruited within 12 weeks of testing positive for HIV. The control group is attention-matched, and follow up assessments will be conducted immediately post intervention (approximately 5 months post diagnosis) and at 10 and 15 months post diagnosis. This study is an important next step in research concerning the adaptive functions of positive affect for people coping with HIV or other health-related life stress. Keywords: positive affect, HIV diagnosis, stress, coping, RCT, intervention, physical health