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CTNPT 029: Psychosocial intervention for older HIV+ adults with HAND

Development of a psychosocial intervention trial with the goal to improve older adults’ ability to cope with HIV-Associated Neurocognitive Disorder (HAND)

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About the study (objectives)

CNTPT 029 will test the feasibility and acceptability of cognitive remediation group therapy in older adults living with HIV who have been diagnosed with HIV-associated neurocognitive disorder (HAND). The cognitive remediation therapy will include tablet-based cognitive training and mindfulness-based stress reduction sessions.

About the disease/condition (background/context)

Approximately half of the aging HIV-positive population will be affected by HAND, making cognitive impairment related to HIV a significant comorbidity in this population. With the development, access to, and early initiation of modern antiretroviral therapy (ART), HAND is less severe and less common than it once was. However, people who were treated with old therapies, ones that were less effective and with higher rates of toxicity compared to current regimens, or who experienced AIDS defining illnesses, may be affected by HAND more frequently and more severely. Issues with cognition, memory, processing new information, problem solving, and decision making are all potential symptoms.

Psychosocial interventions have been used to decrease stress and depression and improve coping and quality of life in the general aging population experiencing cognitive impairment and depression. These techniques, which can vary widely, have not been fully tested in people aging with HAND.

Study Approach (methodology)

CNTPT 029 seeks to enrol 16 people at St. Michael’s Hospital in Toronto. Study participants will be randomized to either receive cognitive remediation group therapy (CRGT) or standard HIV group therapy (control group). Both group therapies consist of a series of weekly 3-hour sessions led by a certified social worker and a peer. The CRGT group will spend one hour per session on brain training exercises (PositScience Software) and the remaining two hours on mindfulness-based stress reduction (meditation, breathing exercises, etc.). The control group will focus on general health and wellbeing for people aging with HIV. Study investigators will determine the usefulness of the structure of the sessions and the feasibility and acceptability of performing a study of this kind.

Eligibility criteria 

Required:

  • Documented HAND diagnosis of Mild Neurocognitive Disorder (MND)
  • 5 years of HIV infection
  • Aged 40 years
  • Provided consent to St. Michael’s Hospital to be contacted for future research studies
  • Able to communicate in English

Not Allowed:

  • Documented HAND diagnosis of asymptomatic neurocognitive impairment (ANI) or HIV-associated dementia (HAD)

Participating Sites

St. Michael’s Hospital
30 Bond Street
Toronto, ON

Additional Information

If you would like more information on this clinical study, please contact the principal investigator.

Principal Investigator

Mr. Andrew Eaton
AIDS Committee of Toronto (ACT), Factor-Inwentash Faculty of Social Work at the University of Toronto
aeaton@actoronto.ca

Publications

Eaton AD, Tsang AKT, Craig SL, Ginocchio GF. Peer researchers in post-professional healthcare: A glimpse at motivations and partial objectivity as opportunities for action researchers. Action Research. 2018 Nov 19;22(1):147675031881191.

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