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Active, Not Recruiting

NCT Number: NCT05704764

Using the Ending Self-Stigma Intervention to Reduce Internalized Stigma Among People Living With HIV Who Use Substances

The goal of this clinical trial is to test an intervention to reduce stigma among people living with HIV who use opioids and cocaine. The main question it aims to answer is:

- Does reducing internalized stigma about HIV and/or drug use lead to improved HIV care outcomes?

After a year spent adapting an existing intervention to be applied specifically among people living with HIV who use substances, 70 participants will be randomized to receive either treatment-as-usual or the newly adapted intervention. The intervention itself will consist of five one-on-one sessions with a trained interventionist to discuss and work through the stigmas people commonly associate with HIV and/or substance use.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Friends Research Institute, Inc. Satellite Office, Newhall, California, United States

Loading trial locations.

About this study

Different types of stigma (e.g., anticipated, enacted, internalized) associated with illicit substance use (SU) and HIV positive status impede HIV treatment outcomes (incl. HIV healthcare retention, antiretroviral therapy [ART] adherence and viral load suppression). The premise of this study is that individuals can learn to diminish the personal effects of public stigma, thereby reducing internalized stigma and improving expected health outcomes.

To this end, this study adapted an existing evidence-based stigma reduction intervention, Ending Self-Stigma (ESS), which has shown efficacy in reducing internalized and anticipated stigma in populations experiencing mental health challenges, to be applied specifically among people living with HIV and using drugs and/or alcohol (or are currently in treatment for substance use). The new one-on-one intervention is IRIS, and it uses cognitive behavioral therapy strategies and social cognitive theory constructs to facilitate reductions in internalized stigma.

In the first phase, an iterative process beginning with formative interviews with service delivery key informants and people living with HIV/AIDS (PLWH) who use substances generated an initial version of IRIS. Intervention content was adapted based on participant feedback and intervention delivery was adapted for a virtual format.

In the second phase, a small pilot of the newly created IRIS intervention was carried out with persons living with HIV and using substances. Feedback from participants and intervention staff were used to refine the IRIS intervention.

In the third phase, a clinical trial testing the newly adapted IRIS intervention will be carried out with 70 participants (Group 1: Minimally Enhanced Treatment-as-Usual; Group 2: IRIS; 1:1 randomization) to determine feasibility and acceptability of the intervention in addition to collecting data on intervening variables (incl. internalized and anticipated stigma, depressive symptoms, anxiety, etc.).

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 18+ years of age
  • English speaking
  • Living with HIV
  • Self-report recent drug and/or alcohol use OR currently enrolled in substance use treatment
  • Willing and able to provide full informed consent
  • Responds affirmatively to having ever experienced one or more of the following types of stigma related to HIV status or SU: (1) enacted, (2) anticipated, and/or internalized.

Exclusion criteria

  • Does not meet all inclusion criteria.

Treatment and study plan

Ending Self Stigma for Persons living with HIV and Use Substances

Behavioral

One-on-one intervention based on principles of cognitive behavioral therapy and social cognitive theory designed to reduce internalized stigma related to HIV and/or drug use.

Other names: IRIS

Primary outcomes

  1. HIV-Related Internalized Stigma

    Time frame: 30 Days

    Change in Berger HIV Stigma scale scores (1 to 4, with higher scores meaning more internalized stigma)

  2. Substance Use-Related Internalized Stigma

    Time frame: 30 days

    Changes in Substance Use Stigma Mechanism scores (1 to 5, with higher scores meaning more internalized stigma)

Secondary outcomes

  1. ART Adherence

    Time frame: 30 days

    Change in self-reported ART adherence (5-point scale, with larger numbers meaning better ART adherence)

  2. Mental Health Symptoms

    Time frame: 7 days

    Changes in CES-D (1 to 4, with larger numbers meaning more depression symptoms) and Spielberger Anxiety (1 to 4, with larger numbers meaning more anxiety) scale scores.

  3. Intervention Satisfaction

    Time frame: 30 days

    Participant intervention satisfaction scores (1 to 5, with larger numbers meaning greater intervention satisfaction)

  4. Substance Use

    Time frame: 30 days

    Self-reported days of substance use

Sponsors and collaborators

Lead sponsor

Friends Research Institute, Inc.

Other

Collaborators

  • Johns Hopkins University
  • National Institute on Drug Abuse (NIDA)
  • University of Maryland

Registry information

Official study title

IRIS: Intervention to Reduce Internalized Stigma (IRIS) Among People Living With HIV Who Use Substances

Acronym: IRIS

Important dates

Study start
2023
Primary completion
2026
Study completion
2026
First posted
Jan 30, 2023
Registry last updated
Jul 20, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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