Feasibility of a Hepatitis C Virus (HCV) Decision-Making Intervention Among HIV-infected Adults (LEAP-C)

Primary Outcome Measures:

• Decrease in decisional conflict related to HCV treatment 12 weeks post treatment [ Time Frame: Up to 12 weeks ]
  Collect data on the study sample at baseline and week 12 to determine whether the intervention decreased decisional conflict.
  
  

Secondary Outcome Measures:

• Proportion of subjects electing HCV treatment 6 months after enrollment in the feasibility study. [ Time Frame: 6 months ]
  Collect data on the study sample to determine the proportion of subjects who began HCV treatment 6 months after enrollment in the study.
  
  
• Increase in knowledge related to HCV treatment 12 weeks post treatment [ Time Frame: Up to 12 weeks ]
  Collect data at baseline and week 12 to determine whether the intervention improved HCV-related knowledge.
  
  
• Increase in communication between subject and health care provider from baseline to week 12. [ Time Frame: Up to 12 weeks ]
  Collect data on the study sample at baseline and week 12 to determine whether the intervention has improved the subjects' perception of communication with their health care provider.
  
  
• Increase in subjects' health related quality of life from baseline to 12 weeks after study enrollment [ Time Frame: Up to 12 weeks ]
  Collect data on the study sample at baseline and week 12 to determine whether the intervention has improved subjects' perception of health related quality of life.
  
  
• Number of symptoms experienced by HCV infected subjects from baseline to week 12 [ Time Frame: Up to 12 weeks ]
  Collect data on the study sample at baseline and week 12 to determine whether the intervention has decreased the number of symptoms experienced by the research subjects.
  
  
• Severity of symptoms experienced by HCV infected subjects from baseline to week 12 [ Time Frame: Up to 12 weeks ]
  Collect data on the study sample at baseline and week 12 to determine whether the intervention has decreased the severity of symptoms experienced by the research subjects.
  
  

Chronic Hepatitis C Virus (HCV) infection is a major problem for Human Immunodeficiency Virus (HIV)-infected patients. Without HCV treatment, increasing numbers of HIV positive patients will die either from end stage liver disease or from HIV-related complications because of the inability to use antiretroviral agents due their hepatotoxicity. Major advances in understanding HCV treatment in this population have occurred within the past several years. Yet, only a small proportion of co-infected patients receive HCV treatment (approximately 15%). Moreover, few studies have explored patient decision-making related to HCV treatment in HIV co-infected patients. The major gap in our knowledge is how best to support patients as they engage in the HCV treatment decision making process with their health care provider. Therefore, the purpose of this phase II study is to test the feasibility of conducting a theoretically-derived group intervention with HIV/HCV co-infected adults to support active engagement in HCV treatment decision-making. The primary aims are to: (1) determine the feasibility of recruiting and retaining a sample of HIV/HCV co-infected adults to complete a protocol that involves randomization into the 4-week HCV Positive Life Skills group intervention or usual care and completion of two data collection interviews (at baseline and week 12), (2) establish the preliminary effect size of the HCV Positive Life Skills group intervention on HCV knowledge, decisional conflict, patient-provider communication, health-related quality of life, symptom experience and engagement with health care providers, (3) explore the capacity of the group intervention to influence HCV knowledge, decisional conflict, patient-provider communication, engagement with health care providers, health related quality of life and symptom experience and (4) describe the components of the intervention and usual care (through qualitative interviews) that are most useful for helping HIV/HCV co-infected patients engage in decision-making about HCV treatment. A mixed method approach will be used. 50 HIV/HCV co-infected participants will be randomized equally to receive either the group intervention or usual care. Then qualitative interviews, using qualitative descriptive methods, will be conducted with 10-12 participants to identify the most salient parts of the intervention and usual care that support effective decision-making about HCV treatment. The investigators will also compare the time spent with both groups, identify variability in the control condition, describe the number of subjects who start HCV treatment and further refine the intervention manual and intervention fidelity procedures in preparation for a full scale multi-site randomized clinical trial.