A pilot randomized controlled trial of acceptance-based behavior therapy to address treatment engagement outcomes and disclosure among new-to-care patients with HIV.

New-to-care people with HIV (PWH) might be uniquely at risk of reduced retention in HIV medical services, but few studies have focused on enhancing retention in this population. This pilot study conducted a randomized trial comparing a brief, 2-session Acceptance-Based Behavior Therapy (ABBT) to an attention-matched HIV education control condition. Primary outcomes were retention in care and viral load (VL). Secondary outcomes were disclosure of HIV status and disclosure self-efficacy, two core targets of ABBT. Due to disruptions caused by the COVID-19 pandemic, the project was terminated early and recruitment goals were not met. However, a sample of n = 36 new-to-care PWH was enrolled from three geographically diverse sites in the United States. Participants in ABBT (n = 20) attended more medical appointments over 12 months than individuals in HIV education (Cohen's d = 0.53; 95%CI: -0.26, 1.31), although this difference was not statistically significant. ABBT showed small to medium effects on secondary outcomes of disclosures of HIV status and disclosure self-efficacy in exploratory analyses. Despite the study's premature termination, results are consistent with, but do not establish, potential ABBT benefit, suggesting further testing in larger trials is needed.Trial registered at clinicaltrials.gov (#NCT04201288).