Supporting Health Among Young Men Who Have Sex With Men and Transgender Women With HIV: Lessons Learned From Implementing the weCare Intervention

Abstract

Young gay, bisexual, and other men who have sex with men and transgender women with HIV, particularly those who are racial or ethnic minorities, often have poor health outcomes. They also utilize a wide array of social media. Accordingly, we developed and implemented weCare, an mHealth (mobile health) intervention where cyberhealth educators utilize established social media platforms (e.g., Facebook, texting, and GPS-based mobile applications [“apps”]) designed for social and sexual networking) to improve HIV-related care engagement and health outcomes. As part of the process evaluation of weCare, we conducted 32 interviews with intervention participants ( n = 18) and HIV clinic providers and staff ( n = 14). This article highlights three key intervention characteristics that promoted care engagement, including that weCare is (1) targeted (e.g., using existing social media platforms, similarity between intervention participants and cyberhealth educator, and implementation within a supportive clinical environment), (2) tailored (e.g., bidirectional messaging and trusting relationship between participants and cyberhealth educators to direct interactions), and (3) personalized (e.g., addressing unique care needs through messaging content and flexibility in engagement with intervention). In addition, interviewees’ recommendations for improving weCare focused on logistics, content, and the ways in which the intervention could be adapted to reach a larger audience. Quality improvement efforts to ensure that mHealth interventions are relevant for young gay, bisexual, and other men who have sex with men and transgender women are critical to ensure care engagement and support health outcomes.

A Rapid Qualitative Assessment of the Impact of the COVID-19 Pandemic on a Racially/Ethnically Diverse Sample of Gay, Bisexual, and Other Men who Have Sex with Men Living with HIV in the US South

“…While participants reported some confusion about conflicting and emerging information related to COVID-19, they utilized multiple and credible sources to obtain information about the pandemic and risk reduction. This finding could reflect, in part, their past participation in the weCare intervention, which improves health literacy by helping participants identify, evaluate, and use online sources of health information, including CDC and HRSA websites [21,23,24]. Thus, despite our sample knowing quite a bit about COVID-19, many PLWH may need support in identifying and accessing correct and updated information to manage their health in light of the dissemination of conflicting information regarding COVID-19.…”

“…In our research with GBMSM living with HIV in the U.S. South, we have found that most own or have access to smartphones; however, most do not have access to desktop computers or laptops at home. Thus, they may not have the requisite technology and/or a private place to participate in telemedicine visits that utilize a video component [21,23,24,27,28]. Transition to telemedicine could potentially reduce HIV care engagement and viral suppression and increase disparities among some of the most vulnerable populations living with HIV.…”

“…We collected qualitative data from participants who had completed 12 months of participation in and had "graduated" from the weCare intervention. weCare is an evidenceinformed intervention that improves HIV care engagement among racially/ethnically diverse GBMSM and transgender women living with HIV by reducing missed HIV care appointments and increasing viral suppression [21,23,24]. weCare currently is being conducted in partnership with the Regional Center for Infectious Diseases (RCID) in Guilford County, NC [21].…”

“…The details of the weCare intervention are described elsewhere [21,23,24]; briefly, weCare harnesses social media platforms, including Facebook messenger, text messaging (including through applications or "apps" such as WhatsApp), and messaging through GPS-based mobile apps used for social and sexual networking (e.g., A4A/ Radar, badoo, Grindr, Jack'd, and Scruff) to improve linkage to and retention in HIV care among PLWH. The intervention is targeted to racially/ethnically diverse GBMSM and transgender women living with HIV, tailored to the social media platform preferences of participants, and personalized to each participant's needs [23].…”

A Uniquely Targeted, Mobile App-Based HIV Prevention Intervention for Young Transgender Women: Adaptation and Usability Study (Preprint)

“…LifeSkills Mobile is among the first mHealth interventions that have been developed to meet the specific and unique needs of YTW to reduce sexual risk for HIV acquisition and transmission. It joins other such mHealth initiatives, focusing on transgender women, which are in the development or testing phases [57][58][59][60].…”