An Adapted Friendship Bench Counseling Intervention (FB) to Improve Mental Health and HIV Care Engagement Outcomes Among People Living with HIV (PWH) Who Inject Drugs in Hanoi, Vietnam: Results from the VITAL Pilot Randomized Controlled Trial.

Abstract

Common mental disorders (CMDs) are prevalent among people living with HIV (PWH) and cause morbidity, jeopardize HIV care engagement, and worsen HIV outcomes. In Vietnam, PWH who inject drugs are at high risk for poor HIV and CMD outcomes. However, few evidence-based interventions are available to address this population. We conducted a three-arm individually randomized pilot trial assigning 75 PWH with opiate use disorder and a CMD from methadone maintenance treatment clinics to either FB by a professional counselor, FB by a peer counselor, or enhanced usual care. Primary outcomes were feasibility, acceptability, and fidelity of FB; we also assessed preliminary indicators of CMD improvement and HIV care engagement. Feasibility was high, with 99% retention at 6 weeks and 96% retention at 6 months. 100% of patients receiving FB attended all 6 weekly sessions. Acceptability of FB was high for participants in both the professional and peer counselor groups. Providers were highly satisfied with the FB experience. Fidelity was adequate: 72% of professional counselors met or exceeded fidelity expectations, while 44% of peer counselors did. Preliminary indicators of effectiveness for CMDs were promising. Participants in the professional counselor arm had the greatest improvement as measured by CMD symptom improvement and CMD response rates at most follow-up visits. The adapted FB intervention should be scaled up and evaluated in a larger, fully powered randomized controlled trial to evaluate its efficacy in improving CMDs and HIV engagement for PWH and CMDs at greatest risk of poor HIV and CMD outcomes.Clinical Trial Number: NCT04790201 registered 3/10/2021.