Nurse-led peer-supported education improves CD4 count and adherence in Thai MSM with HIV

Men who have sex with men (MSM) in Thailand continue to experience a disproportionate HIV burden, with persistent challenges related to antiretroviral therapy (ART) adherence, quality of life, and self-management. Stigma and the scarcity of culturally adapted interventions further hinder sustained engagement in care. This study evaluated the effectiveness of the HIV/AIDS Self-Management Education Program-Thai (HASMEP-T), a culturally adapted, nurse-delivered, peer-supported intervention, on immunologic and patient-reported outcomes among Thai MSM living with HIV. A randomized controlled trial with a pretest-posttest design was conducted at a tertiary HIV clinic, where 64 MSM living with HIV were randomized to either the intervention or control group (n = 32 each). The intervention included four biweekly, 3 h group sessions over 7 weeks, in addition to routine services, while the control group received routine care only. Outcomes measured at baseline, immediately post-intervention, and at the 12-week follow-up included CD4 count, ART adherence, quality of life (WHOQOL-BREF), and HIV self-management. Paired and independent t-tests and repeated-measures ANOVA were employed. At 12 weeks, the intervention group showed significantly greater improvements than the controls in CD4 count (+84.5 cells/mm³), ART adherence (+8.9%), quality of life (+14.7 points), and self-management (+9.1 points) (all p < 0.05). No adverse events were observed. The findings indicate that HASMEP-T is effective in enhancing immunologic, behavioral, and psychosocial outcomes among Thai MSM living with HIV and has the potential to be integrated into routine HIV care to strengthen ART adherence, reduce stigma, and improve quality of life in resource-limited settings.