Thrive With Me: Protocol for a Randomized Controlled Trial to Test a Peer Support Intervention to Improve Antiretroviral Therapy Adherence Among Men Who Have Sex With Men

Horvath, Keith J.; Amico, K Rivet; Erickson, Darin J.; Ecklund, Alexandra M.; Martinka, Aldona; DeWitt, James; McLaughlin, Jeffery; Parsons, Jeffrey T.

doi:10.2196/10182

Cited by 34 publications

(33 citation statements)

References 44 publications

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“…The use of digital strategies to address public health priorities, such as HIV, has increased tremendously in the United States in the last decade [1][2][3][4]. To inform implementation strategies, many survey instruments have been developed to measure contextual attitudes about health technology use across patient populations.…”

Section: Psychometrics In Health Technology Behavior Researchmentioning

confidence: 99%

Using the Patient Portal Sexual Health Instrument in Surveys and Patient Questionnaires Among Sexual Minority Men in the United States: Cross-sectional Psychometric Validation Study (Preprint)

Jackman¹,

Kane²,

Kharrazi³

et al. 2020

Preprint

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BACKGROUND Online health technologies are increasingly being used in medical research and may be useful in addressing the HIV and sexually transmitted infection (STI) burden among gay, bisexual, and other sexual minority men (SMM). Theoretical frameworks in the implementation sciences highlight examining constructs of innovation attributes and performance expectations as key determinants of behavioral intentions and use of new online health technologies. However, behavioral intentions to use patient portals for HIV/STI prevention and care among SMM is understudied. OBJECTIVE The goal of this study is to develop a brief instrument for measuring attitudes focused on using patient portals for HIV/STI prevention and care among a nationwide sample of SMM. METHODS Twelve items of the American Men’s Internet Survey Patient Portal Sexual Health Instrument (AMIS-PPSHI) were adapted from a prior study. Psychometric analyses of the AMIS-PPSHI items were conducted among a randomized subset of 2018 AMIS participants reporting online access to their health records (N=1,375). Parallel analysis and inspection of eigenvalues in a principal component analysis (PCA) informed factor retention in exploratory factor analysis (EFA). After EFA, Cronbach’s alpha (α) was used to examine the internal consistency of the scale and its subscales. Confirmatory factor analysis (CFA) was used to assess goodness of fit of the final factor structure. We calculated total AMIS-PPSHI scale scores for comparisons within group categories, including age, HIV and STI diagnosis history, recency of testing, serious mental illness, and anticipated healthcare stigma. RESULTS The AMIS-PPSHI scale resulting from EFA consisted of 12 items and had good internal consistency (α =.84). The EFA suggested three subscales: 1) Sexual health engagement and awareness (α=.87), 2) Enhancing dyadic communication (α=.87), and 3) Managing sexual health care (α=.79). CFA demonstrated good fit in the 3-factor PPSHI structure; root mean squared error of approximation = .061, comparative fit index = .964, Tucker-Lewis index = .953, and standardized root mean squared residual = .041. The most notable differences were lower scores on the Enhanced dyadic communication subscale among people living with HIV. CONCLUSIONS The PPSHI is a brief instrument with strong psychometric properties that may be adapted for use in large surveys and patient-questionnaires in other settings. Scores demonstrate that patient portals are favorable IT solutions to deliver health services focused on HIV/STI prevention and care among SMM in the United States. More attention is needed to address privacy implications of interpersonal use of patient portals outside of traditional health settings among persons with HIV.

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Section: Psychometrics In Health Technology Behavior Researchmentioning

confidence: 99%

Using the Patient Portal Sexual Health Instrument in Surveys and Patient Questionnaires Among Sexual Minority Men in the United States: Cross-sectional Psychometric Validation Study (Preprint)

Jackman¹,

Kane²,

Kharrazi³

et al. 2020

Preprint

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“…Data for this study were taken from the baseline assessment an ongoing randomized controlled trial (RCT) of the Thrive with Me (TWM) intervention that was launched in October 2016. The TWM intervention and study procedures have been fully described elsewhere (Horvath et al, 2018). Briefly, TWM is a 5-month mobile-optimized online intervention to improve ART adherence among HIV-positive MSM.…”

Section: Participants and Proceduresmentioning

confidence: 99%

“…Participants were recruited by staff at the PRIDE Health Research Consortium (PHRC) in New York City. Recruitment methods included internet-based recruitment efforts, including online venues (websites, email distribution lists, and blogs) and social-medial platforms that cater to MSM and individuals with HIV, as well as field-recruitment strategies such as advertising in clinical settings (Horvath et al, 2018). Eligibility criteria included: (1) current male gender; (2) having sex with a man in the past year; (3) HIV-positive serostatus (confirmed by current ART medication prescription when possible); (4) reporting a detectable VL (past year) or potentially suboptimal ART adherence (< 90% in the past 30 days using a visual analog scale; Amico et al [2006]); (5) English proficiency (since the intervention is in English); (6) residing in the New York City metropolitan area (so that men can attend in-person study visits); ( 7) the ability to send and receive SMS messages; and (8) having internet access over the active (i.e., 5 month) study period.…”

Section: Participants and Proceduresmentioning

confidence: 99%

Defining Sexual Risk in the Era of Biomedical HIV Prevention: Implications for HIV Research and Practice

et al. 2019

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Advancing HIV behavioral science and its integration with recent biomedical prevention strategies-treatment as prevention and pre-exposure prophylaxis (PrEP)-is complicated because traditional definitions of sexual risk (condomless anal sex [CAS] or CAS with a serodiscordant partner) may not suffice given the success of biomedical prevention in the absence of condoms. To better understand how to define and understand risk in the era of biomedical HIV prevention, we assessed correlates of four different definitions of high-risk sexual behavior among a sample of 401 adult HIV-positive MSM (57% African American) residing in the New York City area: (1) a traditional model of risk defined as CAS with an HIV-negative or unknown serostatus partner;(2) a definition that considered participant viral load (VL); (3) a definition that considered partner PrEP use; and (4) a definition that considered participant HIV VL and partner PrEP use. Among participants reporting anal sex (n = 281) with a man in the past 3 months, 42% were considered high risk under Definition 1, 6% under Definition 2, 25% under Definition 3, and 2% under Definition 4. Correlates of risk varied across definitions. For example, while education was the strongest predictor of high-risk sexual behavior in Definitions 1 and 2, alcohol use and enacted stigma were the strongest predictors in the model that only accounted for partner PrEP use (Definition 3). These findings have implications for whom to reach for intervention efforts, the difficulty in meeting recruitment goals, and the types of interventions that should be used.

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“…The Thrive With Me (TWM) intervention was developed by members of this study team and leverages online peer support to improve ART adherence among adult men who have sex with men (MSM) residing in New York City, New York [26]. TWM is a responsive website that adjusts to the size of the device (computer, pad or tablet, or phone) on which it is being viewed.…”

Section: Introductionmentioning

confidence: 99%

“…Improvement in ART adherence outcomes was most pronounced for current (ie, ≤30 days) drug-using MSM among whom the TWM intervention arm reported significantly higher overall ART adherence ( P =.02) and ART taken correctly with food ( P =.01) than those in the control condition. Currently, TWM is being assessed in a large (n=400) efficacy trial of MSM residing in NYC [26].…”

Section: Introductionmentioning

confidence: 99%

Connecting Youth and Young Adults to Optimize Antiretroviral Therapy Adherence (YouTHrive): Protocol for a Randomized Controlled Trial

et al. 2019

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Background Despite intensive efforts to engage people living with HIV in the United States, less than half of the youth aged 13 to 24 years achieve viral suppression. There is a clear and continued need for innovative behavioral programs that support optimizing adherence among young persons with HIV. Objective There are 3 phases of this project. Phase 1 involves conducting focus groups to obtain feedback from youth about an existing technology-based antiretroviral therapy (ART) adherence intervention. Phase 2 will be used to conduct beta testing with youth to refine and finalize the YouTHrive (YT) intervention. Phase 3 is a randomized controlled trial (RCT) to test the efficacy of the YT intervention among youth living with HIV (YLWH). Methods In phase 1, we will conduct 6 focus groups with approximately 8 youths (aged 15-19 years) and young adults (aged 20-24 years), each in 3 US cities to obtain (1) feedback from YLWH about the look and feel and content of an existing adult-focused Web-based ART adherence intervention and (2) suggestions for adapting the intervention for YLWH similar to themselves. Phase 2 will involve updating the existing intervention to include features and functionality recommended by YLWH in phase 1; it will conclude with beta testing with 12 participants to gain feedback on the overall design and ensure proper functionality and ease of navigation. For phase 3, we will enroll 300 YLWH in 6 US cities (Atlanta, Chicago, Houston, New York City, Philadelphia, and Tampa) into a 2-arm prospective RCT. Participants will be randomized 1:1 to YT intervention or control group. The randomization sequence will be stratified by city and use random permuted blocks of sizes 2 and 4. Participants randomized to the control condition will view a weekly email newsletter on topics related to HIV, with the exception of ART adherence, for 5 months. Participants randomized to the YT intervention condition will be given access to the YT site for 5 months. Study assessments will occur at enrollment and 5, 8, and 11 months post enrollment. The primary outcome that will be assessed is sustained viral load (VL), defined as the proportion of participants in each study arm who have suppressed VL at both the 5- and 11-month assessment; the secondary outcome that will be assessed is suppressed VL at both the 5- and 11-month assessment between drug-using and nondrug-using participants assigned to the YT intervention arm. Results Participant recruitment began in May 2017 for phase 1 of the study. The data collection for aim 3 is anticipated to end in April 2020. Conclusions The efficacy trial of the YT intervention will help to fill gaps in understanding the efficacy of mobile interventions to improve ART adherence among at-risk populations. Trial Registration ClinicalTrials.gov NCT03149757; https://clinicaltrials.gov/ct2/show/NCT03149757 (Archived by WebCite at http://www.webcitation.org/73pw57Cf1) International Registered Report Identifier (IRRID) DERR1-10.2196/11502

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Thrive With Me: Protocol for a Randomized Controlled Trial to Test a Peer Support Intervention to Improve Antiretroviral Therapy Adherence Among Men Who Have Sex With Men

Cited by 34 publications

References 44 publications

Using the Patient Portal Sexual Health Instrument in Surveys and Patient Questionnaires Among Sexual Minority Men in the United States: Cross-sectional Psychometric Validation Study (Preprint)

Using the Patient Portal Sexual Health Instrument in Surveys and Patient Questionnaires Among Sexual Minority Men in the United States: Cross-sectional Psychometric Validation Study (Preprint)

Defining Sexual Risk in the Era of Biomedical HIV Prevention: Implications for HIV Research and Practice

Connecting Youth and Young Adults to Optimize Antiretroviral Therapy Adherence (YouTHrive): Protocol for a Randomized Controlled Trial

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