The Skills to Manage Pain Randomized Trial: Results of Antiretroviral Therapy Adherence, HIV Primary Care Retention, and Virologic Suppression Outcomes.

BACKGROUND

People with HIV commonly endorse chronic pain contributing to poor HIV outcomes. This study is a secondary analysis of a multisite randomized control trial that improved pain with a behavioral pain treatment, Skills to Manage Pain (STOMP), among People with HIV and chronic pain. We examined whether participants randomized to STOMP, as compared with enhanced usual care (EUC), evidenced improved HIV outcomes at the 12-month follow-up visit.

SETTING

Participants (N = 278) were recruited from Center for AIDS Research Network of Integrated Clinical Systems clinics in Alabama and NC. Eligible participants were randomized to receive either STOMP, combined 1-on-1 skill-building sessions delivered by staff interventionists with group sessions co-led by peer interventionists, or EUC.

METHODS

We compared 12-month outcomes of adherence to antiretroviral therapy (ART), retention in HIV care, virologic suppression. We used logistic regressions using generalized estimating equations to account for correlations within groups and were adjusted for baseline values.

RESULTS

At baseline, most participants were virologically suppressed (STOMP: 95.2%; EUC: 93.6%) and adherent to ART (≥90% medication taken past month; STOMP: 93.6%, EUC: 89.0%). There were no significant differences between EUC and STOMP for adherence to ART, retention in HIV care, or virologic suppression at the 12-month follow-up (all p 's > 0.16).

CONCLUSIONS

Participants receiving STOMP had no differences in 12-month HIV outcomes, despite improvements in chronic pain severity at 3 months. High baseline adherence may have created a ceiling effect on changes.

TRIAL REGISTRATION: Clinical Trials Registration #NCT03692611.