TY - JOUR
T1 - Increases in employment over six months following Khanya
T2 - A secondary analysis of a pilot randomized controlled trial of a peer-delivered behavioral intervention for substance use and HIV medication adherence in Cape Town, South Africa
AU - Belus, Jennifer M.
AU - Regenauer, Kristen S.
AU - Lu, Thanh
AU - Murphy, Sean M.
AU - Rose, Alexandra L.
AU - Ochieng, Yvonne Akinyi
AU - Joska, John
AU - Majokweni, Sybil
AU - Andersen, Lena S.
AU - Myers, Bronwyn
AU - Safren, Steven A.
AU - Magidson, Jessica F.
N1 - Publisher Copyright:
© 2024
PY - 2024
Y1 - 2024
N2 - Introduction: Evidence suggests that brief, skills-based behavioral interventions are effective at improving clinical outcomes related to substance use and HIV, but little data exists on whether such interventions can incidentally improve employment. We examined preliminary changes in employment over six months following Khanya, a brief peer-delivered behavioral intervention to reduce substance use and improve antiretroviral therapy (ART) adherence compared to enhanced treatment as usual (ETAU). Methods: Adults living with HIV (N = 61) with at least moderate substance use and ART non-adherence were recruited from a primary care clinic in Khayelitsha, South Africa, a community with high rates of unemployment. Participants were randomized 1:1 to Khanya versus ETAU and assessed at baseline, 3- and 6-months. Employment was categorized as unemployed, casually, or full-time employed. Multilevel modeling was used to predict log odds and probability of categorical employment status over time, by arm. Results: At baseline, 78.7% of the sample were unemployed, 16.4% were casually employed, and 4.9% were employed full-time. There was a significant increase in employment in both treatment arms at 3-months (p = 0.03) but only the Khanya arm demonstrated significant increases at 6-months (p = 0.02). At 6-months, 59% of participants in Khanya had any employment (from 13% at baseline), compared to 38% in ETAU (from 29% at baseline). Conclusions: Study data suggest a brief behavioral intervention for substance use and ART adherence may support employment among people with HIV living in a resource-constrained community. However, future research with larger sample sizes and longer-term follow ups is needed to replicate these findings. Trial registration: ClinicalTrials.gov identifier: NCT03529409. Trial registered on May 18, 2018
AB - Introduction: Evidence suggests that brief, skills-based behavioral interventions are effective at improving clinical outcomes related to substance use and HIV, but little data exists on whether such interventions can incidentally improve employment. We examined preliminary changes in employment over six months following Khanya, a brief peer-delivered behavioral intervention to reduce substance use and improve antiretroviral therapy (ART) adherence compared to enhanced treatment as usual (ETAU). Methods: Adults living with HIV (N = 61) with at least moderate substance use and ART non-adherence were recruited from a primary care clinic in Khayelitsha, South Africa, a community with high rates of unemployment. Participants were randomized 1:1 to Khanya versus ETAU and assessed at baseline, 3- and 6-months. Employment was categorized as unemployed, casually, or full-time employed. Multilevel modeling was used to predict log odds and probability of categorical employment status over time, by arm. Results: At baseline, 78.7% of the sample were unemployed, 16.4% were casually employed, and 4.9% were employed full-time. There was a significant increase in employment in both treatment arms at 3-months (p = 0.03) but only the Khanya arm demonstrated significant increases at 6-months (p = 0.02). At 6-months, 59% of participants in Khanya had any employment (from 13% at baseline), compared to 38% in ETAU (from 29% at baseline). Conclusions: Study data suggest a brief behavioral intervention for substance use and ART adherence may support employment among people with HIV living in a resource-constrained community. However, future research with larger sample sizes and longer-term follow ups is needed to replicate these findings. Trial registration: ClinicalTrials.gov identifier: NCT03529409. Trial registered on May 18, 2018
KW - Behavioral intervention
KW - Employment
KW - HIV
KW - Medication adherence
KW - South Africa
KW - Substance use
U2 - 10.1016/j.drugpo.2024.104632
DO - 10.1016/j.drugpo.2024.104632
M3 - Journal article
C2 - 39577326
AN - SCOPUS:85209674322
VL - 134
JO - International Journal of Drug Policy
JF - International Journal of Drug Policy
SN - 0955-3959
M1 - 104632
ER -