RecruitingNot ApplicableNCT05934305

Mitigating the Impact of Stigma and Shame Among People Living With HIV and Substance Use Disorders

Mitigating the Impact of Stigma and Shame as a Barrier to Viral Suppression Among People Living With HIV and Substance Use Disorders

Sponsor

Boston University

Enrollment

256 participants

Start Date

Mar 12, 2025

Study Type

INTERVENTIONAL

Conditions

Substance Use Disorders HIV

Summary

People living with HIV and substance use disorders (SUDs) are less likely to be virally suppressed, which can lead to HIV transmission and negative health outcomes. This hybrid type 1 study will assess the efficacy, mechanisms, as well as facilitators and barriers to implementing the MATTER intervention, a virtually delivered 5-session text-enhanced psychobehavioral intervention designed to facilitate viral suppression by addressing internalized stigma and shame as barriers to engagement in HIV care among individuals living with HIV and SUDs in two locations with different levels of HIV resources (i.e., the Boston, Massachusetts and Miami, Florida metro areas). MATTER aims to mitigate the negative behavioral consequences of internalized stigma and shame on viral suppression by a) developing behavioral self-care goal setting skills and related self-efficacy, b) increasing metacognitive awareness (i.e., non-judgmental awareness of emotions and cognitions), and c) teaching and reinforcing compassionate self-restructuring (i.e., self- compassion), in addition to providing access to phone-based resource navigation. Scalable interventions such as MATTER are essential to our efforts to end the HIV epidemic in high priority regions.

Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study is testing a program designed to reduce the shame and stigma felt by gay, bisexual, or transgender men who are living with both HIV and a substance use disorder, and whose HIV is not well controlled. The goal is to reduce internalized stigma and improve HIV medication adherence. **You may be eligible if...** - You are HIV-positive and 18 or older - You have a substance use disorder (not solely tobacco, cannabis, or alcohol) - Your HIV viral load is detectable (above 20 copies/mL) - You experience internalized stigma related to HIV, substance use, sexual orientation, or gender identity - You identify as a gay or bisexual man, or as transgender - You can read in English or Spanish and communicate verbally in English - You have or can be provided a cell phone with text messaging **You may NOT be eligible if...** - You are a cisgender woman - You are a cisgender heterosexual man Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

BEHAVIORALMatter Intervention

This 5-session text-enhanced intervention is designed to mitigate the negative behavioral consequences of internalized stigma and shame among individuals with SUDs that perpetuate sub-optimal engagement in HIV self-care and consequently inconsistent viral suppression. The intervention involves five virtually delivered one-on-one therapy sessions focused on behavioral goal setting skill development and related self-efficacy, increasing meta-cognitive awareness (i.e., non-judgmental awareness of emotions and cognitions), and teaching and reinforcing compassionate self-restructuring (i.e., self-compassion). Participants also receive daily text messages querying emotions during the one-on-one portion of the intervention. For eight weeks after the one-on-one portion, participants receive their compassionate self-statements via text in response to their indicated emotions. Participants will also receive phone-based resource navigation, as needed.

BEHAVIORALControl Condition

The control condition will involve five sessions of prerecorded asynchronous content related to local resources (e.g., information related to substance use treatment and other ancillary services).