Protocol for a Pilot Randomized Controlled Trial of a Resilience Intervention Adapted for Older People Living with HIV: Resilience Intervention for Successful Aging Enhancement (RISE+)

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Purpose: Despite evidence that: 1) older people living with HIV (PLHIV) experience a high burden of stress that is associated with myriad poorer outcomes, 2) psychological resilience may buffer the negative effects of stress in older PLHIV, and 3) older PLHIV may possess lower levels of this protective factor than seronegative counterparts, little work has examined strategies to bolster resilience in older PLHIV. This article details the protocol for a pilot clinical trial examining the feasibility and efficacy of a theory-driven resilience intervention that has been adapted for older PLHIV. Patients and Methods: This study plans to randomize 100 older PLHIV aged 45+ with suboptimal HIV treatment management to either an intervention condition (i.e., Resilience Intervention for Successful Aging Enhancement [RISE+]) or an attention-matched control condition. Both arms include weekly one-hour in person group intervention sessions. The comprehensive assessment includes proximal mechanistic measures, (i.e., real-time measurement of resilience resources and stress reactivity and recovery via experience sampling method [ESM] text message-prompted online surveys) and health (i.e., psychological functioning and HIV outcomes) measures. Primary Aims focus on intervention effects on: the use of resilience resources and whether such increases drive improved affective stress reactivity and recovery (Aim 1) and distal health outcomes at three months (Aim 2). Conclusions: This study tests a novel resilience intervention among older PLHIV and has several strengths, including focusing on an at-risk and understudied population, rigorous examination of efficacy and mechanism, and utilizing an intervention with minimal facilitator involvement, which has implications for future scalability. Findings will identify intervention mechanisms and inform the development of potent and scalable interventions for building resilience in older PLHIV and other diverse populations of older adults.

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