AIDSImpact Special Issue: Mobilizing individual social capital resources for HIV care support: results of a pilot intervention in St. Petersburg, Russia

Less than half of people living with HIV (PLH) in Russia are on antiretroviral therapy (ART), and only 27% are virally suppressed. Interventions to better engage PLH in medical care could reduce onward transmission and also improve health. A feasibility pilot test of an intervention to increase social capital to support HIV care engagement was carried out in St. Petersburg. Out-of-care or care-nonadherent PLH (n=24) attended a five-session group intervention to (1) help participants enter care, initiate ART, and adhere to ART and (2) identify and access social capital resources—such as family members, friends, and care providers—to mobilize their supports for HIV care. Participants were assessed at baseline, at followup immediately after intervention (FU-1), and again at 6-month followup (FU-2) with HIV viral load testing and measures of HIV care engagement, ART adherence, and social capital. At FU-1, participants reported talking more frequently and with a greater number of friends about HIV care experiences, verifying the intervention’s mechanism of action. Participants increased in scores on scales measuring medication-taking adherence (p=0.002 at FU-1 and p=0.011 at FU-2), HIV medication-taking self-efficacy (p=0.042 at FU-1), and HIV medication-taking outcome expectancies (at FU-2, p=0.016 among persons on ART and p=0.026 among those not on ART). HIV Medication Readiness scale scores increased at FU-1 (p=0.032) among persons not on ART, although some changes became attenuated over time. Participants tended to keep their care appointments more frequently (79% at baseline to 90% at FU-1; p=0.077); to have undetectable viral load (54% at baseline to 74% at FU-2; p=0.063); and to have fewer days in the past month with delayed or incomplete medication doses (from 7.8 at baseline to 4.2 at FU-1; p=0.084). This social capital intervention is novel and promising for improving HIV care-related outcomes, and warrants a full-scale evaluation.