# Targeting HIV Retention and Improved Viral load through Engagement ('THRIVE')

> **NIH NIH R34** · BAYLOR COLLEGE OF MEDICINE · 2021 · $293,231

## Abstract

Summary/ abstract:
Poor retention in HIV primary care results in lower rates of HIV viral suppression, higher rates of HIV
transmission, and exacerbates racial and ethnic disparities in health outcomes, including survival. To date,
there are no interventions that effectively relink and retain PWH in care when they are found outside the HIV
clinic. Many persons with HIV infection (PWH) are hospitalized with life-threatening but preventable
complications of inadequately treated HIV infection. They are among the most important patients to retain in
care. Our previous research shows that among PWH who are out of care and hospitalized, avoidance
coping, stigma, and mental health difficulties were nearly universal. Further, avoidance coping was a
predictor of failure to re-engage in care after discharge. Acceptance and Commitment Therapy (ACT) is a
transdiagnostic intervention with the capacity to address a range of psychosocial and behavior-related
issues that PWH experience. ACT helps patients overcome avoidance, particularly avoidance of
uncomfortable internal states and the situations that trigger such states, by promoting acceptance-based
coping and re-engagement in meaningful and valued-life activities. Brief ACT interventions appear to be
feasible, acceptable, and at least preliminarily, have efficacy. We propose to develop, refine, and pilot a
brief (4-5 contact hours) ACT intervention for hospitalized, out-of-care PWH. `Targeting HIV Retention and
Improved Viral load through Engagement' (`THRIVE') will aim to help patients overcome avoidance, a
maladaptive coping strategy implicated in a range of problems, including depression, anxiety, substance
abuse, and HIV-related self-stigma, all of which constitute barriers to care. Delivering THRIVE in the
hospital with a phone booster session after discharge will increase therapy initiation and completion, the
lack of which is often the greatest obstacle to effective delivery of mental health services for PWH. In Aim 1,
a brief hospital-based transdiagnostic, individually delivered ACT intervention (THRIVE) tailored specifically
for out-of-care hospitalized PWH will be developed. Input from a multi-disciplinary team of expert care
providers and PHW will be utilized to create the therapist protocol and patient workbook. We will then pilot
THRIVE in 10 hospitalized out-of-care PWH who will provide qualitative feedback on the intervention. The
feedback, along with input from patients and the multi-disciplinary team, will be used to refine THRIVE. In
Aim 2, we will conduct a pilot randomized clinical trial (RCT) of the refined THRIVE intervention (N=35)
compared to treatment as usual (N=35). This pilot RCT will 1) evaluate feasibility and acceptability for a full-
scale RCT; and 2) examine trends in outcomes of interest for the definitive RCT. We will then be positioned
to submit a separate grant to test the efficacy of THRIVE in a fully powered randomized trial. This work has
the potential to decrease HI...

## Key facts

- **NIH application ID:** 10219136
- **Project number:** 5R34MH122294-02
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** Lilian Nazar Dindo
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $293,231
- **Award type:** 5
- **Project period:** 2020-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10219136

## Citation

> US National Institutes of Health, RePORTER application 10219136, Targeting HIV Retention and Improved Viral load through Engagement ('THRIVE') (5R34MH122294-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10219136. Licensed CC0.

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