Addressing HIV care, mental health and substance use among youth and young adults in the Bay Area: description of an intervention to improve information, motivation and behavioural skills

McCuistian, Caravella; Wootton, Angie R.; Legnitto-Packard, Dominique; Gruber, Valerie A.; Dawson–Rose, Carol; Johnson, Mallory O.; Saberi, Parya

doi:10.1136/bmjopen-2020-042713

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Our study is significant because it has the potential to be effective while improving ART adherence and virologic suppression among a key population experiencing health disparities, YWH. This research builds on our prior work using technology-based interventions to improve HIV clinical outcomes among YWH [19,32,[37][38][39][40][41]. Our intervention is innovative because we will use a novel aDOT-CEI intervention among YWH who are not virologically suppressed.…”

Section: Discussionmentioning

confidence: 99%

Youth Ending the HIV Epidemic (YEHE): Protocol for a pilot of an automated directly observed therapy intervention with conditional economic incentives among young adults with HIV

Stoner,

Ming,

Wagner

et al. 2023

PLoS ONE

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Background Young adults have a disproportionately high rate of HIV infection, high rates of attrition at all stages of the HIV care continuum, and an elevated probability of disease progression and transmission. Tracking and monitoring objective measures of antiretroviral therapy (ART) adherence in real time is critical to bolster the accuracy of research data, support adherence, and improve clinical outcomes. However, adherence monitoring often relies on self-reported and retrospective data or requires additional effort from providers to understand individual adherence patterns. In this study, we will monitor medication-taking using a real-time objective measure of adherence that does not rely on self-report or healthcare providers for measurement. Methods The Youth Ending the HIV Epidemic (YEHE) study will pilot a novel automated directly observed therapy-conditional economic incentive (aDOT-CEI) intervention to improve ART adherence among youth with HIV (YWH) in California and Florida who have an unsuppressed HIV viral load. The aDOT app uses facial recognition to record adherence each day, and then economic incentives are given based on a participant’s confirmed adherence. We will enroll participants in a 3-month pilot study to assess the feasibility and acceptability of the aDOT-CEI intervention using predefined metrics. During and after the trial, a subsample of the pilot participants and staff/providers from participating AIDS Healthcare Foundation (AHF) clinics will participate in individual in-depth interviews to explore intervention and implementation facilitators and barriers. Discussion YEHE will provide data on the use of an aDOT-CEI intervention to improve adherence among YWH who are not virologically suppressed. The YEHE study will document the feasibility and acceptability and will explore preliminary data to inform a trial to test the efficacy of aDOT-CEI. This intervention has the potential to effectively improve ART adherence and virologic suppression among a key population experiencing health disparities. Trial registration The trial registration number is NCT05789875.

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Section: Discussionmentioning

confidence: 99%

Youth Ending the HIV Epidemic (YEHE): Protocol for a pilot of an automated directly observed therapy intervention with conditional economic incentives among young adults with HIV

Stoner,

Ming,

Wagner

et al. 2023

PLoS ONE

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“…Intervention for Virologic Suppression in Youth (iVY) aims to address MH and SU in a tailored manner using a differentiated care approach that is youth-friendly. 35 iVY combines two components to address SU and MH among YWH: (1) brief weekly sessions with a counsellor via a video-chat platform (video-counselling) to discuss MH, SU, HIV care engagement and other barriers to care 37 38 ; and (2) a mobile health app called WYZ designed and developed using a Human Centered Design approach with YWH to address barriers. 39 40 The primary goal is to address important, distinct and changing barriers to HIV care engagement (eg, MH, SU, forgetting, social isolation) 41–44 among YWH.…”

Section: Introductionmentioning

confidence: 99%

iVY: protocol for a randomised clinical trial to test the effect of a technology-based intervention to improve virological suppression among young adults with HIV in the USA

Saberi,

Stoner,

McCuistian

et al. 2023

BMJ Open

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IntroductionYoung adults with HIV (YWH) experience worse clinical outcomes than adults and have high rates of substance use (SU) and mental illness that impact their engagement in care and adherence to antiretroviral therapy (ART). The intervention for Virologic Suppression in Youth (iVY) aims to address treatment engagement/adherence, mental health (MH) and SU in a tailored manner using a differentiated care approach that is youth friendly. Findings will provide information about the impact of iVY on HIV virological suppression, MH and SU among YWH who are disproportionately impacted by HIV and at elevated risk for poor health outcomes.Methods and analysisThe iVY study will test the effect of a technology-based intervention with differing levels of resource requirements (ie, financial and personnel time) in a randomised clinical trial with an adaptive treatment strategy among 200 YWH (18–29 years old). The primary outcome is HIV virological suppression measured via dried blood spot. This piloted and protocolised intervention combines: (1) brief weekly sessions with a counsellor via a video-chat platform (video-counselling) to discuss MH, SU, HIV care engagement/adherence and other barriers to care; and (2) a mobile health app to address barriers such as ART forgetfulness, and social isolation. iVY has the potential to address important, distinct and changing barriers to HIV care engagement (eg, MH, SU) to increase virological suppression among YWH at elevated risk for poor health outcomes.Ethics and disseminationThis study and its protocols have been approved by the University of California, San Francisco Institutional Review Board. Study staff will work with a Youth Advisory Panel to disseminate results to YWH, participants and the academic community.Trial registration numberNCT05877729.

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The Need for Community-Responsive and Flexible Sex Ed for Historically Marginalized Youth

et al. 2022

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Introduction When it is offered, sexuality education in the USA is far from standardized. While studies have explored differences in delivery and type of sexuality education across the USA, sexual and reproductive health inequities persist among historically marginalized groups (Latino/a/x, Black, African American, LGBTQ +). There is a critical need to better understand the systemic barriers to receiving effective sexuality education in these communities. Methods Participatory research methods were used in working with a community advisory board (CAB)—consisting of emerging adults and service providers from community-based organizations (CBOs) serving youth—to examine how structural barriers contribute to adolescent sexual and reproductive health (ASRH) inequities in Massachusetts. CAB meetings and semi-structured interviews were conducted in the cities of Springfield ( n = 14) and Lynn ( n = 9) between December 2020 and May 2021. Results Inflexible funding guidelines, a related evidence-based curricular mandate, and a lack of community-responsive sexuality education fail to meet the sexual and reproductive health (SRH) needs of these youth. Conclusions Current evidence-based mandates must be revisited to improve young people’s access to quality sexuality information in public schools. To guarantee sexuality education curricula is centered in the context of the community and population in which it is implemented, collaboration between youth-serving CBOs and school districts could improve students’ overall experience and social-emotional growth by providing comprehensive, positive, and community-responsive curricula. Policy Implications Funders and programming should prioritize community responsiveness by financially supporting and developing and/or adapting evidence-based curricula to better match the community’s needs, which can be completed through culture-centered training and community-based partnership.

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Addressing HIV care, mental health and substance use among youth and young adults in the Bay Area: description of an intervention to improve information, motivation and behavioural skills

Cited by 3 publications

References 23 publications

Youth Ending the HIV Epidemic (YEHE): Protocol for a pilot of an automated directly observed therapy intervention with conditional economic incentives among young adults with HIV

Youth Ending the HIV Epidemic (YEHE): Protocol for a pilot of an automated directly observed therapy intervention with conditional economic incentives among young adults with HIV

iVY: protocol for a randomised clinical trial to test the effect of a technology-based intervention to improve virological suppression among young adults with HIV in the USA

The Need for Community-Responsive and Flexible Sex Ed for Historically Marginalized Youth

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