Trial Outcomes & Findings for Improving the Health of South African Women With Traumatic Stress in HIV Care (C0147) (NCT NCT02223390)

NCT ID: NCT02223390

Last Updated: 2024-07-24

Results Overview

Self-report, measured by the PTSD checklist, civilian version (PCL-5). 20-item self-report questionnaire, assessed severity of symptoms that parallel the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) diagnostic criteria for PTSD. Participants were asked to indicate the extent to which they were bothered by problems experienced in the past month in relation to a traumatic experience of abuse or act of violence (0 = not at all to 4 = extremely). Total severity score (range: 0-80; higher scores indicating higher symptom severity, \>= 33 indicating PTSD) and subscale totals (Avoidance - Cluster C, range: 0-8, higher scores indicating higher avoidance symptom severity; and Hyperarousal - Cluster E, range: 0-24, higher scores indicating higher hyperarousal symptom severity) were examined.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

64 participants

Primary outcome timeframe

90 Days, 180 days

Results posted on

2024-07-24

Participant Flow

Participant milestones

Participant milestones
Measure
Mental Health Treatment
The experimental condition, ImpACT, was developed in the pilot phase of the study. The intervention will be 4 sessions of individual psychological treatment related to stress, coping, and HIV adherence, followed by three group sessions. Sessions will follow an intervention manual and be delivered by a psychiatric nurse (or equivalent nonspecialist in mental health) who is supervised by a trained clinical psychologist. Improving AIDS Care after Trauma (ImpACT)
Standard of Care
Participants in standard of care will receive the three-session adherence counseling delivered in the clinic, along with referrals for trauma treatment.
Overall Study
STARTED
32
32
Overall Study
COMPLETED
23
28
Overall Study
NOT COMPLETED
9
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Mental Health Treatment
The experimental condition, ImpACT, was developed in the pilot phase of the study. The intervention will be 4 sessions of individual psychological treatment related to stress, coping, and HIV adherence, followed by three group sessions. Sessions will follow an intervention manual and be delivered by a psychiatric nurse (or equivalent nonspecialist in mental health) who is supervised by a trained clinical psychologist. Improving AIDS Care after Trauma (ImpACT)
Standard of Care
Participants in standard of care will receive the three-session adherence counseling delivered in the clinic, along with referrals for trauma treatment.
Overall Study
Lost to Follow-up
9
4

Baseline Characteristics

Improving the Health of South African Women With Traumatic Stress in HIV Care (C0147)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Mental Health Treatment
n=32 Participants
The experimental condition, ImpACT, was developed in the pilot phase of the study. The intervention will be 4 sessions of individual psychological treatment related to stress, coping, and HIV adherence, followed by three group sessions. Sessions will follow an intervention manual and be delivered by a psychiatric nurse (or equivalent nonspecialist in mental health) who is supervised by a trained clinical psychologist. Improving AIDS Care after Trauma (ImpACT)
Standard of Care
n=32 Participants
Participants in standard of care will receive the three-session adherence counseling delivered in the clinic, along with referrals for trauma treatment.
Total
n=64 Participants
Total of all reporting groups
Age, Continuous
29.2 years
STANDARD_DEVIATION 6.6 • n=99 Participants
29.0 years
STANDARD_DEVIATION 8.4 • n=107 Participants
29.1 years
STANDARD_DEVIATION 7.5 • n=206 Participants
Sex: Female, Male
Female
32 Participants
n=99 Participants
32 Participants
n=107 Participants
64 Participants
n=206 Participants
Sex: Female, Male
Male
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
32 Participants
n=99 Participants
32 Participants
n=107 Participants
64 Participants
n=206 Participants
Race (NIH/OMB)
White
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Region of Enrollment
South Africa
32 participants
n=99 Participants
32 participants
n=107 Participants
64 participants
n=206 Participants
PTSD Symptoms (PCL-5)
PCL - total symptom severity score
43.28 units on a scale
STANDARD_DEVIATION 21.94 • n=99 Participants
30.72 units on a scale
STANDARD_DEVIATION 20.27 • n=107 Participants
37.00 units on a scale
STANDARD_DEVIATION 21.89 • n=206 Participants
PTSD Symptoms (PCL-5)
PCL - Cluster C Avoidance
4.53 units on a scale
STANDARD_DEVIATION 2.93 • n=99 Participants
3.03 units on a scale
STANDARD_DEVIATION 2.62 • n=107 Participants
3.78 units on a scale
STANDARD_DEVIATION 2.86 • n=206 Participants
PTSD Symptoms (PCL-5)
PCL - Cluster E Arousal
12.88 units on a scale
STANDARD_DEVIATION 7.25 • n=99 Participants
8.31 units on a scale
STANDARD_DEVIATION 6.34 • n=107 Participants
10.59 units on a scale
STANDARD_DEVIATION 7.15 • n=206 Participants

PRIMARY outcome

Timeframe: 90 Days, 180 days

Self-report, measured by the PTSD checklist, civilian version (PCL-5). 20-item self-report questionnaire, assessed severity of symptoms that parallel the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) diagnostic criteria for PTSD. Participants were asked to indicate the extent to which they were bothered by problems experienced in the past month in relation to a traumatic experience of abuse or act of violence (0 = not at all to 4 = extremely). Total severity score (range: 0-80; higher scores indicating higher symptom severity, \>= 33 indicating PTSD) and subscale totals (Avoidance - Cluster C, range: 0-8, higher scores indicating higher avoidance symptom severity; and Hyperarousal - Cluster E, range: 0-24, higher scores indicating higher hyperarousal symptom severity) were examined.

Outcome measures

Outcome measures
Measure
Mental Health Treatment
n=32 Participants
The experimental condition, ImpACT, was developed in the pilot phase of the study. The intervention will be 4 sessions of individual psychological treatment related to stress, coping, and HIV adherence, followed by three group sessions. Sessions will follow an intervention manual and be delivered by a psychiatric nurse (or equivalent nonspecialist in mental health) who is supervised by a trained clinical psychologist. Improving AIDS Care after Trauma (ImpACT)
Standard of Care
n=32 Participants
Participants in standard of care will receive the three-session adherence counseling delivered in the clinic, along with referrals for trauma treatment.
PTSD Symptoms
PCL - total symptom severity (3 mos)
25.79 score on a scale
Standard Error 5.40
23.04 score on a scale
Standard Error 3.60
PTSD Symptoms
PCL - total symptom severity (6 mos)
28.61 score on a scale
Standard Error 5.04
22.50 score on a scale
Standard Error 3.47
PTSD Symptoms
PCL - Cluster C Avoidance (3 mos)
2.21 score on a scale
Standard Error 0.63
2.23 score on a scale
Standard Error 0.39
PTSD Symptoms
PCL - Cluster C Avoidance (6 mos)
2.96 score on a scale
Standard Error 0.60
2.71 score on a scale
Standard Error 0.47
PTSD Symptoms
PCL - Cluster E Hyperarousal (3 mos)
7.47 score on a scale
Standard Error 1.36
8.00 score on a scale
Standard Error 1.21
PTSD Symptoms
PCL - Cluster E Hyperarousal (6 mos)
7.91 score on a scale
Standard Error 1.54
6.75 score on a scale
Standard Error 1.10

PRIMARY outcome

Timeframe: 180 days

Population: Subset of participants newly initiating ART (excluding re-initiators and non-initiators; n=54, 49 with biomarker data)

Assessed through biomarkers of dried blood spots (DBS) testing for presence of antiretroviral therapy (ART) (tenofovir, emtricitabine, and efavirenz) at 6 month assessment, supplemented by viral load (VL; considered adherent if VL \<=40 copies/ml) when DBS unavailable. Outcome dichotomized.

Outcome measures

Outcome measures
Measure
Mental Health Treatment
n=23 Participants
The experimental condition, ImpACT, was developed in the pilot phase of the study. The intervention will be 4 sessions of individual psychological treatment related to stress, coping, and HIV adherence, followed by three group sessions. Sessions will follow an intervention manual and be delivered by a psychiatric nurse (or equivalent nonspecialist in mental health) who is supervised by a trained clinical psychologist. Improving AIDS Care after Trauma (ImpACT)
Standard of Care
n=26 Participants
Participants in standard of care will receive the three-session adherence counseling delivered in the clinic, along with referrals for trauma treatment.
HIV Medication Adherence (% Adherent)
19 Participants
15 Participants

Adverse Events

Mental Health Treatment

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Standard of Care

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Kathleen Sikkema, PhD

Duke University (Currently at Columbia University)

Phone: 212-305-8236

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place