Positive Outlook is a 7-module intervention targeting psychosocial consequences of HIV in men who have sex with men (MSM) with HIV using psychoeducation, discussion boards, and live chat conducted in small groups
Positive Outlook is a 7-module internet based intervention for MSM who have HIV targeting psychosocial consequences related to HIV. Researchers developed Positive Outlook based on needs assessments derived from literature searches and surveys and interviews with MSM who have HIV and service providers. Over 7 weeks, participants complete 7 intervention modules lasting about 90 minutes. Modules included education, goal setting and action planning activities, and small group discussions with other participants on discussion boards. Modules address stress management, depression, disclosure, relationships, disclosure to intimate partners, risks within intimate relationships, and medication. Users interact with other users in small groups led by a peer facilitator over a private message board (asynchronous communication) or at weekly chat meetings (real-time communication). Peer facilitators encourage and moderate discussions, send feedback, and answer questions.
Psychosocial consequences of HIV
Young Adults (18-30)
Summary: Researchers conducted a pilot feasibility study (Pilot 1) and randomized controlled trial (Pilot 2) evaluating Positive Outlook. Researchers recruited 10 men who have sex with men (MSM) with HIV through the Western Australian AIDS Council to use Positive Outlook for Pilot 1. Participants completed a post-intervention interview about intervention ease of use and satisfaction. Participants also completed assessments of HIV-specific quality of life, health education impact, HIV-specific self-efficacy, depression and anxiety, social support, general self-efficacy, and adjustment to HIV at baseline and post-intervention. Pilot 1 participants (n=6) reported Positive Outlook was easy to navigate and were satisfied with intervention content. Pilot 1 participants reported significantly improved HIV-related quality of life, HIV-related self-efficacy, and depression symptoms after using Positive Outlook. Researchers recruited 35 MSM with HIV using web- and print-based advertisements for Pilot 2. Participants were randomized to complete Positive Outlook (n=17) or to receive usual care (n=18). Positive Outlook participants reported significantly improved HIV-related quality of life, depression symptoms, and general self-efficacy. No significant between-group differences were observed. Pilot 2 participants found Positive Outlook to be useful and reported the discussion boards as the most useful features.
Take Away: Participants found the Positive Outlook online intervention useful and acceptable. Pilot studies indicated potential of the program for producing improvements in psychosocial outcomes, but did not produce between-group differences.
The Positive Outlook study: A randomized controlled trial evaluating online self-management for HIV positive gay men
Summary: Researchers recruited 132 men who have sex with men (MSM) with HIV and randomized them to receive Positive Outlook (n=68) or usual care (UC; n=64) for 7 weeks. Participants who received Positive Outlook completed the intervention in closed online groups led by a peer facilitator. Researchers sent weekly reminders about the program to participants. Participants completed assessments of HIV-specific quality of life, health education impact, and HIV-specific self-efficacy at baseline, post-intervention, and 12-weeks follow-up. Positive Outlook participants experienced significantly greater improvements in some aspects of HIV-related quality of life than UC participants between baseline and post-intervention (i.e. emotional distress) and baseline and 12 weeks (i.e., body change, social relationships). Positive Outlook participants experience significantly greater improvements than UC participants in self-management skills in the health-directed activity subscale between baseline and 12-weeks follow-up, the constructive attitudes and approaches subscale between baseline and post-intervention, the skill and technique acquisition subscale between baseline and post-intervention, health service navigation between baseline and post-intervention. Finally, Positive Outlook participants experienced significantly greater improvements than UC participants in HIV-related self-efficacy in the relationships, social participation, and emotions subscales between baseline and post-intervention.
Take Away: MSM with HIV who received Positive Outlook experienced significantly greater improvements in psychosocial outcomes than MSM who received care as usual, but between group differences were generally not sustained to 12 weeks post-intervention.