African Americans living with HIV and serious mental illness (AALWH and SMI) experience multi-level barriers to treatment engagement including... Show moreAfrican Americans living with HIV and serious mental illness (AALWH and SMI) experience multi-level barriers to treatment engagement including structural discrimination, HIV and SMI stigma, medical mistrust, and poor patient-provider relationships. Personal resources such as HIV treatment self-efficacy and active coping are identified in the extant literature as buffers to barriers to treatment engagement, and may be mechanisms by which individuals living with HIV engage effectively with treatment. Using Community-Based Participatory Research (CBPR) the current study piloted a culture-specific, group-level psychoeducational intervention to improve treatment engagement among AALWH and SMI (N = 16). Overall, acceptability for intervention was high (M(SD) = 33.18(5.66) [range 6-42]). Inferential statistics indicate significant increases in CD4+ counts; HIV treatment self-efficacy, perseverance; psychological appointment attendance; and instrumental support seeking. Additionally, there was a statistically significant decrease in medical appointment attendance and self-distraction coping. An increase in ART engagement, and a decrease in viral load were also observed, however these results were not statistically significant. The peer-led intervention was highly accepted by participants. Participants demonstrated increases in HIV treatment self-efficacy, psychological appointment attendance, and CD4+ counts following completion of the intervention; however, had worse medical appointment attendance. The author highlights the clinical significance of the findings here. Taken together, results support mixed outcomes for the CBPR-developed and peer-led intervention. Show less
