This application responds to the President's HIV Care Continuum Initiative to improve the proportion of HIV- infected persons engaged in care by developing a theory-based Avatar mobile phone intervention that engages young HIV-positive African American men who have sex with men (AAMSM) in three of the five stages of care: (1) retention, (2) HAART adherence, and (3) viral suppression. The intervention will maximize the likelihood of compliance with healthy behavior leading to both patient benefits (decreased morbidity, mortality and resistant viru s) and population benefits (decreased HIV transmission). MSM account for more than three-fourths of new HIV infections among men and nearly half of these are AAMSM. In addition, they are less likely to take highly active antiretroviral therapy and have viral suppression. We will systematically develop and then evaluate the feasibility, acceptability, utilization, and preliminary impact of a theory-based innovative Avatar mobile phone application to engage young HIV-infected AAMSM in multiple stages of the HIV Care Continuum. The intervention draws on the Information Motivation Behavioral Skills Model that focuses on feedback between information and motivation that affect one's behavioral skills, behaviors, and desired health outcomes. The Avatar will encourage interaction with information and functions that promote engagement with the HIV Care Continuum, provide fundamental HIV information, provide motivating statements, facilitate interaction with healthcare, visualize laboratory results, and encourage, explain, and even illustrate relevant behavioral skills. We will (1) Develop an Avatar-based mobile phone application; (2) Perform participatory formative research with 4 sequential focus groups of 6 HIV-infected AAMSM (N=24) to revise the Avatar-based app in order to ensure maximum acceptability among the target population; (3) Evaluate the app to determine acceptability, feasibility, utilization and preliminary effects including bloo draw and HIV clinic return visit compliance, pill count and self reported adherence, and viral load suppression in 50 HIV-infected AAMSM (5 beta testers and 45 pilot subjects) and (4); Revise the app based on survey and oral input from pilot study participants. If successful, the Avatar will be subsequently tested in a large scale randomized controlled trial with AAMSM.
Retention in care, adherence to antiretroviral therapy, and viral suppression are all necessary for the successful treatment of HIV infection. This exploratory/developmental application proposes to systematically develop and then evaluate the feasibility, acceptability, utilization, and preliminary impact of a theory-based innovative Avatar mobile phone application to engage young HIV-infected African American men who have sex with men in multiple stages of the HIV Care Continuum. The impact of this theory-based intervention includes preservation of health in African American men who have sex with men and decreased likelihood of future transmission of HIV.
| Dworkin, Mark; Chakraborty, Apurba; Lee, Sangyoon et al. (2018) A Realistic Talking Human Embodied Agent Mobile Phone Intervention to Promote HIV Medication Adherence and Retention in Care in Young HIV-Positive African American Men Who Have Sex With Men: Qualitative Study. JMIR Mhealth Uhealth 6:e10211 |
