Improving AIDS Care After Trauma (ImpACT): Pilot Outcomes of a Coping intervention Among HIV-Infected Women with Sexual Trauma in South Africa.

Journal Article (Journal Article)

Improving AIDS Care after Trauma (ImpACT), a coping intervention for HIV-infected women with sexual abuse histories, was evaluated for feasibility and potential efficacy in a public clinic in Cape Town, South Africa. Sixty-four participants were enrolled prior to starting antiretroviral therapy (ART). After completing baseline assessments, participants were randomly assigned to standard of care (SoC: three adherence counseling sessions) or ImpACT (SoC plus four individual and three group sessions). Participants completed assessments at 3 months (after individual sessions) and 6 months post-baseline. In exploratory analysis of primary outcomes, ImpACT participants, compared to SoC, reported greater reductions in avoidance and arousal symptoms of PTSD and greater increases in ART adherence motivation at 3 months. Clinically significant decreases in overall PTSD symptoms were also demonstrated at 3 months. These effects continued as trends at the 6-month assessment, in addition to increases in social/spiritual coping. In analysis of secondary outcomes, high levels of non-adherence to ART and poor care engagement were evident at 6 months, with no differences between study arms. A trauma-focused, culturally-adapted individual intervention delivered by a non-specialist in the HIV care setting is feasible and acceptable. Preliminary findings suggest ImpACT has potential to reduce PTSD symptoms and increase ART adherence motivation, but a more intensive intervention may be needed to improve and maintain care engagement among this population.

Trial registration NCT02223390.

Full Text

Duke Authors

Cited Authors

  • Sikkema, KJ; Mulawa, MI; Robertson, C; Watt, MH; Ciya, N; Stein, DJ; Cherenack, EM; Choi, KW; Kombora, M; Joska, JA

Published Date

  • March 2018

Published In

Volume / Issue

  • 22 / 3

Start / End Page

  • 1039 - 1052

PubMed ID

  • 29270789

Pubmed Central ID

  • PMC5828984

Electronic International Standard Serial Number (EISSN)

  • 1573-3254

International Standard Serial Number (ISSN)

  • 1090-7165

Digital Object Identifier (DOI)

  • 10.1007/s10461-017-2013-1


  • eng