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Randomized Controlled Trial
. 2022 Dec;26(12):3897-3913.
doi: 10.1007/s10461-022-03717-2. Epub 2022 Jun 7.

Randomized Controlled Trial of a Remote Coaching mHealth Adherence Intervention in Youth Living with HIV

K Rivet Amico  1 , Jane C Lindsey  2 , Michael Hudgens  3 , Ronald Dallas  4 , Keith J Horvath  5 , Amanda Dunlap  6 , Rachel Goolsby  3 , Megan Mueller Johnson  6 , Barbara Heckman  7 , Jessica Crawford  6 , Elizabeth Secord  8 , Murli Purswani  9 , Danial Reirden  10 , Mobeen Rathore  11 , Lisa-Gaye Robinson  12 , Aditya H Gaur  4 ; TERA Study Team
Affiliations
Randomized Controlled Trial

Randomized Controlled Trial of a Remote Coaching mHealth Adherence Intervention in Youth Living with HIV

K Rivet Amico et al. AIDS Behav. 2022 Dec.

Abstract

Youth living with HIV (YLWH) in the US have low rates of viral suppression (VS). In a prospective randomized clinical trial (ATN152) that enrolled 89 YLWH on antiretroviral therapy (ART) with detectable viral load, we evaluated a 12 week triggered escalating real-time adherence (TERA) intervention with remote coaching, electronic dose monitoring (EDM), and outreach for missed/delayed doses compared to standard of care (SOC). Median [Q1, Q3] percent days with EDM opening was higher in TERA (72% (47%, 89%)) versus SOC (41% (21%, 59%); p < 0.001) and incidence of numbers of 7 day gaps between openings were lower (TERA to SOC ratio: 0.40; 95% CI 0.30, 0.53; p < 0.001). There were no differences in VS at week 12 (TERA 35%; 95% CI 21%, 51% versus SOC 36%; 95% CI 22%, 51%; p > 0.99) or later time-points. The intervention improved adherence but not VS in heavily ART-experienced YLWH. Remote coaching more closely tailored to the unique dosing patterns and duration of need for youth struggling to reach VS warrants further investigation.

Keywords: Coaching; EDM; Intervention; Viral suppression; YLWH; Youth; mHealth.

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Conflict of interest statement

The authors report no financial interests and no conflicts of interest relevant to the subject matter discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Consort diagram. Grayed text represents post COVID-19 pandemic related pause in data collection- not used in primary analyses
Fig. 2
Fig. 2
Viral Suppression and Viral Load Outcomes
Fig. 3
Fig. 3
Median percent days EDM device opened by week
Fig. 4
Fig. 4
Scatterplot (LOESS line) of log10 HIV-1 RNA vs. GAP IR and percent days opened (PCT12) by 12-week period
See this image and copyright information in PMC

References

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