MEDICAL ADHERENCE AND COPING WITH THE CONSEQUENCES OF HIV INFECTION

Grant Title: Understanding the Social and Psychological Context of Acute HIV Infection

Funding Source and Project Period:
Supplement to NIMH P30 Center Grant; 2006-2008

HIV Center Key Personnel:

Principal Investigator: Anke A. Ehrhardt, Ph.D.
Co-Investigators: Robert H. Remien, Ph.D.; Jennifer Hirsch, Ph.D.

Project Overview:

Acute HIV infection refers to the stage of infection when virus is in the blood but antibodies cannot yet be detected through enzyme immunoassay and Western Blot testing.  This phase can last from days to 3-4 months.  At least one of the following symptoms is found in about half of those with acute HIV infection: fever, joint pain, inguinal lymphadenopathy and night sweats.  Very high viral loads and very high infectiousness characterize this early stage of infection.  Modeling suggests that acute infections are an important driving force in the generalized HIV epidemic of heterosexual transmission in Sub-Saharan Africa, as well as in concentrated epidemics within the US.

Although studies indicate that most people reduce their sexual risk behavior for a period of time after first finding out that they are HIV-positive, these studies were conducted with people who tested positive on an HIV antibody test with a wide range of time since actual infection.  With the advancement of technology that can detect acute infection, it is likely that increasing numbers of people will be able to be identified in the earliest stages of infection, prior to the development of HIV antibodies.  It is important to explore prevention opportunities during the acute stage of infection when individuals are significantly more infectious to their sex partners.

The purpose of this study is to collect data that could lead to behavioral interventions to prevent HIV transmission during acute infection.  The study's three specific aims are to determine the feasibility of identifying and recruiting individuals with acute HIV infection for prevention research; to better understand the social and psychological context of recent HIV transmissions; and to assess sexual behavior, substance use, and psychological state of individuals with acute infection.

This study is part of a multi-site initiative coordinated and funded by NIMH in which each of six sites (NYSPI/Columbia University, UCSF, UCLA, UCSD, Yale University, and Medical College of Wisconsin) will collect data from 10 individuals with acute HIV infection.  Participants will complete semi-structured qualitative interviews and a structured behavioral assessment to better understand how these cases are detected, the social and psychological context of recent HIV transmissions, and motivations for behavior change in this group.

updated 05/16/07