Improving caregiver coping to support family members engaged in addiction and HIV treatment
1
Arizona State University, Phoenix, United States
2
UCLA, Los Angeles, United States
3
Anova Health Institute, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1316
ABSTRACT
BACKGROUND:
Injection drug use is expanding globally, compromising HIV prevention and treatment strategies. In South Africa, only 36% of those who inject drugs are virally suppressed, with 38% continuing on opioid substitution therapy (OST).1 Caregiver approaches to support people who inject drugs in treatment outcomes are limited, with more intervention development needed.2-4
METHODS:
A pilot randomized controlled trial of a coping and communication intervention to improve HIV treatment and OST continuation was delivered, with 46 caregivers (family members) participating in the intervention arm. Family members (27-66 years, 78% were female) received four skill-building sessions in group and dyadic formats, with measures for coping, support, caregiver burden and intervention feasibility collected at Months 0 and 3. Thematic analyses was conducted on interview data, and linear mixed models was used to evaluate survey and behavioral measures.
RESULTS:
Family member retention was 95% completing all sessions and study visits, with similar ratings for intervention feasibility, acceptability, willingness and safety. Many family members described value in learning with others about stress management and demonstrated improved understanding of addiction and treatment. Notably, they reported applying new skills in their support activities, reflecting resiliency behaviors. Family member coping significantly increased from baseline to Month 3 (MTime1 = 2.13, MTime2 = 2.34, p = .03, d = .36), social support improved (MTime1 = 5.04, MTime2 = 5.26, p = .29, d = .19), and caregiver burden decreased (MTime1 = 1.69, MTime2 = 1.48, p = .13, d = -.31).
CONCLUSIONS:
Family member caregivers of those who inject drugs require coping and communication skills to facilitate their role in treatment engagement. The intervention demonstrates potential to harness family members to improve HIV and OST outcomes in settings where drug use is expanding and family is a key social determinant of health, with implications for clinical guidelines.
Injection drug use is expanding globally, compromising HIV prevention and treatment strategies. In South Africa, only 36% of those who inject drugs are virally suppressed, with 38% continuing on opioid substitution therapy (OST).1 Caregiver approaches to support people who inject drugs in treatment outcomes are limited, with more intervention development needed.2-4
METHODS:
A pilot randomized controlled trial of a coping and communication intervention to improve HIV treatment and OST continuation was delivered, with 46 caregivers (family members) participating in the intervention arm. Family members (27-66 years, 78% were female) received four skill-building sessions in group and dyadic formats, with measures for coping, support, caregiver burden and intervention feasibility collected at Months 0 and 3. Thematic analyses was conducted on interview data, and linear mixed models was used to evaluate survey and behavioral measures.
RESULTS:
Family member retention was 95% completing all sessions and study visits, with similar ratings for intervention feasibility, acceptability, willingness and safety. Many family members described value in learning with others about stress management and demonstrated improved understanding of addiction and treatment. Notably, they reported applying new skills in their support activities, reflecting resiliency behaviors. Family member coping significantly increased from baseline to Month 3 (MTime1 = 2.13, MTime2 = 2.34, p = .03, d = .36), social support improved (MTime1 = 5.04, MTime2 = 5.26, p = .29, d = .19), and caregiver burden decreased (MTime1 = 1.69, MTime2 = 1.48, p = .13, d = -.31).
CONCLUSIONS:
Family member caregivers of those who inject drugs require coping and communication skills to facilitate their role in treatment engagement. The intervention demonstrates potential to harness family members to improve HIV and OST outcomes in settings where drug use is expanding and family is a key social determinant of health, with implications for clinical guidelines.
| eISSN: | 2654-1459 |
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