Video-Counseling Intervention to Address HIV Care Engagement, Mental Health, and Substance Use Challenges: A Pilot Randomized Clinical Trial for Youth and Young Adults Living with HIV

Abstract

Background: Substance use and mental health are two barriers to engagement in care and antiretroviral therapy (ART) adherence among youth and young adults living with HIV (YLWH). The consequences of suboptimal adherence in YLWH are increased risk of HIV transmission and a future generation of immunodeficient adults with drug-resistant virus. Methods: The Youth to Telehealth and Texting for Engagement in Care (Y2TEC) study was a pilot randomized crossover trial that examined the feasibility and acceptability of a novel video-counseling series and accompanying text messages aimed at mental health, substance use, and HIV care engagement for YLWH. The intervention consisted of twelve 20–30-min weekly video-counseling sessions focused on identifying and addressing barriers to HIV care, mental health, and substance use challenges. Participants completed quantitative surveys at baseline, 4 months, and 8 months. Feasibility and acceptability were evaluated using prespecified benchmarks. Results: Fifty YLWH aged 18–29 years living in the San Francisco Bay Area were enrolled. Eighty-six percent and 75% of participants were retained at 4 and 8 months, respectively. A total of 455 (76%) video-counseling sessions were completed. In 82% of sessions, participants responded that they strongly agreed/agreed with this statement: “I felt heard, understood, and respected by the counselor.” In 81% of sessions, participants responded that they strongly agreed/agreed with this statement: “Overall, today's session was right for me.” At baseline, among participants reporting mental health challenges, only 10% noted having ever received mental health services, and among those who reported substance use challenges, ∼19% reported ever receiving substance use services. After 4 months of the Y2TEC intervention, participants reported slightly higher ART adherence and HIV knowledge, decreased depression and anxiety, and reduced stigma related to mental health and substance use. Conclusions: The Y2TEC intervention using video-counseling and text messaging was feasible and acceptable for YLWH. ID: NCT03681145

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

“…Preliminary evidence on effectiveness also indicated improvement in ART adherence, HIV knowledge, mental health symptoms, and stigma related to mental health and substance use problems 4 months following the intervention. 11 Fidelity to the intervention was assessed during weekly meetings with the counsellors to review each session's length, technical issues, topics covered, goals established and narrative progress notes. Counsellors also completed a fidelity checklist for each session to determine if the focus area was identified, if education/information was provided, if barriers were identified, if motivation was enhanced and if problem solving was initiated.…”

“…7 Detailed key findings of the trial are published elsewhere and discussed in further detail in the discussion of the current paper. 11…”

Behavioral and social interventions to promote optimal HIV prevention and care continua outcomes in the United States

“…Many interventions over the past year focused on priority populations such as sexual minority cisgender men, transgender women of color, and youth, who may experience multiple forms of stigma and co-occurring mental health concerns. For example, Saberi et al [32] developed an intervention using video counseling and mobile texting for young people living with HIV -the majority of whom were Latino or Black gay menand found promising short-term effects on ART…”

Student Youth Health Culture in System Managing the Quality of Higher Education

“…Much higher rates for smoking and low alcohol use are higher for males, while for females they are much lower and there is no craving for drugs at all [4,19,20]. Taking into account the influence of the environment, it is necessary to actively promote a healthy lifestyle among students through educational talks, cultural events, and sports events, because this is an effective and economically feasible strategy aimed at providing domestic enterprises and institutions with highly qualified, healthy professionals in particular, and for the health of the nation in general.…”

“…However, over the last decade, the internet has become an even more pernicious internet addiction which includes gambling. Unlike other destructive passions, internet addiction is more difficult to diagnose and is not realized by man or the immediate environment, because, at first glance, it does not violate the perception of a healthy lifestyle [2, 19,22].…”