Self-Management in HIV-Positive Women in China: A Pilot Randomized Controlled Trial

Purpose: China is experiencing a rapid increase in the number of HIV infections. It is estimated that approximately 780,000 people are infected with HIV in China, 80% of whom are unaware that they are infected. The objective of this study was to conduct an intervention to assist self-management in HIV-positive women in China.

Methods: This was a pilot randomized controlled trial (RCT) with blinded assessment. Participants were randomized to intervention or treat-as-usual (TAU) arms. The study occurred at two outpatient clinics in Shanghai and Beijing, China. Participants were 33 HIV-positive women who receiving care in either clinics in Beijing or Shanghai with thirteen in the intervention arm and eighteen in the TAU arm. The nurse-delivered intervention involved three, hour-long, face-to-face sessions over 4 weeks. Intervention content included relaxation, family support, coping skills, anxiety, stress, and depression management, cognitive-behavioral management and psycho-educational classes. The primary outcome were self-reported self-efficacy, social support and quality of life.  

Results: Study participants average age was 42.5 years old, range from 19-70 years old.  Majority of them were Han ethnicity (80.6%), and married (64.5%). Many of them (51.6%) were still full time or part time.  In addition, more than half (58.1%) of the participants did not graduate from high school.  About half of them (54.8%) have enough or barely adequate income to support the family.  In all cross-sectional and longitudinal analyses, at both post-intervention (4 weeks) and follow-up (13 weeks) effects were in the hypothesized directions.  Despite the small sample size, most of these between-arm comparisons were marginal statistically significant. 

Conclusions: Our results suggest that self-management intervention will enhance the self-management in HIV-positive Chinese women and assist them to utilize more family support to ease the disease burden. In addition, nurse interventionist can deliver a counselling intervention in a clinic setting with the potential to decrease the disease stress and increase the coping skills of the HIV-positive women.  Findings warrant future trials powered for efficacy.