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NCT03464422: ESTEEM-conneCT

Adapting an Evidence-based Intervention for Stigma-related Stress, Mental Health, and HIV Risk for MSM of Color in Small Urban Areas

Completed NA Results posted Last updated 4 August 2021
What this trial tests

NA trial testing ESTEEM conneCT in HIV in MSM in 21 participants. Completed in 1 August 2019.

Timeline
9 September 2018
Primary endpoint
1 August 2019
1 August 2019

Quick facts

Lead sponsorYale University
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposeprevention
Enrollment21
Start date9 September 2018
Primary completion1 August 2019
Estimated completion1 August 2019
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Yale University

Who can join

Adults 18 to 35, any sex, with HIV in MSM. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Depression Primary · 3 months

To measure depression in participants, the Center for Epidemiological Studies - Depression Scale (CES-D) will be used. An overall depression score is computed as the sum of the 20 items, with Items 3, 11, 14, and 16 reversed. In cases with internally missing data (items not answered), the sums were computed after imputation of the missing values: # items on scale / # actually answered, multiplied by the sum obtained from the answered items. A higher score indicates more depressive symptomatology during the past week. Range is 0 - 60.

Baseline
GroupValue95% CI
ESTEEM ConneCT22.10± 11.89
3-month follow-up
GroupValue95% CI
ESTEEM ConneCT20.35± 12.01
HIV Transmission Risk Primary · 90 days

Risk of HIV transmission was assessed through the Past-90-day Timeline Follow-back interview (TLFB; Sobell \& Sobell, 1992). HIV risk behavior was calculated as the number of past-90-day sex acts in which key harm-reduction strategies were not employed (e.g., condom, PrEP, viral load suppression) and calculated by dividing the total number of sex acts at risk for HIV transmission by the total number of sex acts. Sex acts range from 0 to (theoretically) infinite.

Baseline
GroupValue95% CI
ESTEEM ConneCT4.10± 10.12
3-month follow-up
GroupValue95% CI
ESTEEM ConneCT8.29± 11.38
Overall Depression Severity and Impairment Scale Secondary · 3 months

ODSIS (Bentley et al., 2014) is a 5-item scale that asks individuals to rate the severity and impairment associated with past-week symptoms of depression (e.g., "In the past week, when you have felt depressed, how intense or severe was your depression?) from 0 (little or none: Depression was absent or barely noticeable.) to 4 (extreme: Depression was overwhelming.). Scores range from 0-20, with higher scores indicating greater depression and associated impairment in the past week.

Baseline
GroupValue95% CI
ESTEEM conneCT11.00± 4.79
3-month follow-up
GroupValue95% CI
ESTEEM conneCT10.53± 6.07
Overall Anxiety Severity and Impairment Scale Secondary · 3 months

OASIS (Norman et al., 2006) is a 5-item scale that asks individuals to rate the severity and impairment associated with past-week anxiety symptoms (e.g., "In the past week, when you have felt anxious, how intense or severe was your anxiety?") from 0 (little or none: Anxiety was absent or barely noticeable.) to 4 (extreme: Anxiety was overwhelming. It was impossible to relax at all. Physical symptoms were unbearable). Scores range from 0-20, with higher scores indicating greater anxiety and associated impairment in the past week.

Baseline
GroupValue95% CI
ESTEEM ConneCT12.05± 3.54
3-month follow-up
GroupValue95% CI
ESTEEM ConneCT11.88± 6.07
Brief Symptom Inventory Secondary · 3 months

(BSI; Derogatis \& Melisarators, 1983; Meijer et al., 2011). The Global Severity Index of the 18-item BSI provides a mean score across depression, anxiety, and somatization subscales, and assesses psychological distress (e.g., "feeling nervousness or shakiness inside") on a 5-point scale from 0 (not at all) to 4 (extremely) in the past 7 days. Scores range from 0-72, with higher scores indicating worse outcomes (greater symptoms severity).

Baseline
GroupValue95% CI
ESTEEM ConneCT2.12± 0.87
3-month follow-up
GroupValue95% CI
ESTEEM ConneCT2.05± 1.03
Suicidal Ideation Attributes Scale Secondary · 3 months

SIDAS (van Spijker et al., 2014) is a 5-item scale that assesses past-month frequency and controllability of suicidal thoughts, how close one has come to making an attempt, and distress and impairment associated with thoughts of suicide (e.g., "In the past month, how often have you had thoughts about suicide?"). Responses range from 0 (never or not at all) to 10 (always or extremely) on each item, with item 2 reverse scored. Scale scores range from 0-50, with higher scores indicating more (worse) suicidal ideation

Baseline
GroupValue95% CI
ESTEEM ConneCT4.33± 9.63
Post-treatment
GroupValue95% CI
ESTEEM ConneCT3.41± 8.20
Alcohol Use Disorders Identification Test Secondary · 3 months

The AUDIT (Saunders et al.,1993) assesses past-3-month alcohol and related problems across 10 items (e.g., "How often did you have a drink containing alcohol?") with varying numeric response options. A score of 8 or greater serves as a clinical cut-off indicating hazardous drinking. Scores range from 0-40 with higher scores indicating more hazardous drinking (worse outcome)

Baseline
GroupValue95% CI
ESTEEM ConneCT16.90± 6.57
Post-treatment
GroupValue95% CI
ESTEEM ConneCT17.53± 8.77
Condom-use Self-Efficacy Questionnaire Secondary · 3 months

The SSSEQ assesses respondents' confidence in condom use during sex in different scenarios. Example items include, "How confident are you that you could avoid having anal sex without a condom when you are with someone who is really hot?" and "How confident are you that you could avoid having anal sex without a condom when you are drink or high on drugs?". Response options range from 1 (Not at all confident) to 5 (extremely confident). Scores range from 1 - 65 with higher scores indicating greater self-efficacy around practicing safe sex (better outcome)

Baseline
GroupValue95% CI
ESTEEM ConneCT48.05± 16.33
Post-treatment
GroupValue95% CI
ESTEEM ConneCT49.24± 14.32
Sexual Compulsivity Scale Secondary · 3 months

The SCS (Kalichman \& Rompa, 2011) assesses respondents' compulsivity around sex. Example items include "My desires to have sex have disrupted my daily life" and "My sexual thoughts and behaviors are causing problems in my life", with response options ranging from 1 (Not at all like me) to 4 (Very much like me). Scores range from 1 - 40 with higher scores indicating greater sexual compulsivity (worse outcome)

Baseline
GroupValue95% CI
ESTEEM ConneCT18.38± 7.11
3-month follow-up
GroupValue95% CI
ESTEEM ConneCT18.18± 8.89
Gay-Related Rejection Sensitivity Scale Secondary · 3 months

The GRRS (Pachankis, Goldfried \& Ramrattan, 2008) asks respondents to rate 14 vignettes in terms of how concerned or anxious each would make them about being rejected because of their sexual orientation, and their likelihood of attributing the rejection to their sexual orientation. For example, one item states, "You've been dating someone for a few years now and you receive a wedding invitation to a straight friend's wedding. The invite was addressed only to you, not you and a guest". Responses to the anxiety and likelihood stems range from 1 (very unconcerned/very unlikely) to 6 (very concer

Baseline
GroupValue95% CI
ESTEEM ConneCT10.73± 5.66
3-month follow-up
GroupValue95% CI
ESTEEM ConneCT9.92± 5.97
Self-concealment Scale Secondary · 3 months

The SCS (Larson \& Chastain, 1990; Schrimshaw, Siegel, Downing \& Parsons, 2013) assesses the respondents' concealment of their sexual orientation. Example items include, "I haven't shared with anyone that I have sex with men" and "When I have sex with men, I keep it to myself". Response options range from 1 (strongly disagree) to 5 (strongly agree). Scale scores range from 7-35 with higher scores indicating greater concealment of one's sexual orientation.

Baseline
GroupValue95% CI
ESTEEM ConneCT2.15± 0.97
3-month follow-up
GroupValue95% CI
ESTEEM ConneCT2.01± 0.95
Internalized Homophobia Scale Secondary · 3 months

The IHS assesses internalized stigma related to respondents' sexual orientation, asking them to rate thoughts and feelings related to their LGBTQ identity (e.g., "You have wished you weren't gay, bisexual, or queer). Responses range from 1 (never) to 4 (often). Scale scores range from 9 - 36 with higher scores indicating greater internalized stigma (worse outcome).

Baseline
GroupValue95% CI
ESTEEM ConneCT1.53± 0.68
3-month follow-up
GroupValue95% CI
ESTEEM ConneCT1.53± 0.78

Sponsor's own description

The purpose of this study is adapt an evidence-based intervention for stigma-related stress, mental health, and HIV risk for bay, bisexual, and other men who have sex with men (MSM) of color in small urban areas.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

  1. A pilot test of a treatment to address intersectional stigma, mental health, and HIV risk among gay and bisexual men of color.
    Jackson SD, Wagner KR, Yepes M, Harvey TD, et al · · 2022 · cited 40× · PMID 35025569 · DOI 10.1037/pst0000417

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