Search:
Scroll to top
Tag: HIV
06/12/2023

Findings From the Step Up, Test Up Study of an Electronic Screening and Brief Intervention for Alcohol Misuse in Adolescents and Young Adults Presenting for HIV Testing: Randomized Controlled Efficacy Trial

Karnik N, Kuhns L, Hotton A, Del Vecchio N, McNulty M, Schneider J, Donenberg G, Keglovitz Baker K, Diskin R, Muldoon A, Rivera J, Summersett Williams F, Garofalo R. Findings From the Step Up, Test Up Study of an Electronic Screening and Brief Intervention for Alcohol Misuse in Adolescents and Young Adults Presenting for HIV Testing: Randomized Controlled Efficacy Trial. JMIR Ment Health 2023;10:e43653. DOI: 10.2196/43653

This study tested the efficacy of a fully automated electronic screening and brief intervention, Step Up, Test Up, to reduce alcohol misuse among adolescents and young adults in community-based HIV testing environments in Chicago. Effects on sexual risk and uptake of pre-exposure prophylaxis (PrEP) for HIV prevention were also examined. Three hundred twenty-nine participants aged 16-25 years who identified as a man or transgender woman who has sex with men and reported moderate to high alcohol use were randomly assigned to a brief single-visit intervention or attention control condition (modules of similar length on promotion of diet and nutrition). The Step Up, Test Up intervention used a motivational interviewing approach to deliver lessons on 11 topics focused on alcohol use. Data were collected at 1, 3, 6, and 12-months post intervention. There were no significant group differences in alcohol use outcomes over time. There was a significant but small reduction in condomless anal sex under the influence of alcohol and drugs at 12 months compared to 3 months among participants in the intervention group relative to the control group (incidence rate ratio=0.15, 95% CI 0.05-0.44). There were no significant group differences in sexual risk and PrEP engagement. The relative lack of effect of the intervention on alcohol misuse and associated risks may reflect a need for cultural tailoring and more dynamic and engaging components in the intervention.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ; ;
02/06/2023

A Peer-Led Online Community to Increase HIV Self-Testing Among African American and Latinx MSM: A Randomized Controlled Trial

Young SD, Cumberland WG, Singh P, Coates T. A Peer-Led Online Community to Increase HIV Self-Testing Among African American and Latinx MSM: A Randomized Controlled Trial. J Acquir Immune Defic Syndr. 2022 May 1;90(1):20-26. doi: 10.1097/QAI.0000000000002919. PMID: 35044989; PMCID: PMC8986620.

Researchers conducted a randomized controlled trial to assess the effectiveness of a peer-led online community for increasing HIV self-testing among Latinx and African American men who have sex with men (MSM). Nine hundred MSM living in Los Angeles were recruited from online advertisements, community centers and referrals. Eligible participants were HIV negative and/or serostatus unknown. Seventy-nine peer leaders were also recruited from local community organizations and attended training sessions on HIV epidemiology, building an online community, and promoting discussion on health and stigmatizing topics. Participants randomly assigned to the intervention joined a 12-week private online community group with peer leaders on Facebook and the control group joined a private Facebook group without peer leaders. Each group had about 30 participants and 5 peer leaders. During the intervention period, peer leaders communicated with participants weekly via sending messages, chats, and posts in their Facebook group to build trust and deliver HIV information. Every four weeks, all participants were offered a free HIV self-testing kit. All participants were administered self-report assessments at baseline and at 12-weeks at post-intervention. Results indicated the intervention group was significantly more likely to accept the offer for self-testing compared to the control group (OR=1.43, 95% CI 1.04 to 1.95). Compared to the control, intervention participants were significantly more likely to take a HIV self-test within the past 3 months (OR=1.47, 95% CI 1.01 to 2.13) and consume less alcohol in an average week (p=0.01) at post-intervention follow-up relative to baseline. The study observed a high retention rate (93%). Findings suggest that online communities are effective platforms for increasing HIV testing and reducing alcohol consumption among MSM of color. Results have implications for public health policy and scalability of technology-based interventions.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ;
01/09/2023

New mHealth Intervention Aims to Curb Smoking Among Black HIV Patients

Article Excerpt: Following a $1.3 million grant from the National Institute of Drug Abuse, Lorra Garey, a researcher from the University of Houston RESTORE Lab, plans to lead a research project to assess the impact of an mHealth application to mitigate smoking among Black people with HIV. HIV, a virus that attacks the body’s immune system, affects a large portion of the worldwide population. According to the World Health Organization, it has led to 40 million deaths globally. In addition, the US Department of Veterans Affairs noted that about 20 percent of US citizens with HIV are not aware that they have it, according to the press release.

Full Article: https://tinyurl.com/456cr8fh

Article Source: mHealthIntelligence

Posted in: Emerging Technologies // Tagged: ; ; ; ; ; ; ; ; ;
12/05/2022

A Mobile Intervention to Link Young Female Entertainment Workers in Cambodia to Health and Gender-Based Violence Services: Randomized Controlled Trial

Brody C, Chhoun P, Tuot S, Fehrenbacher A, Moran A, Swendeman D, Yi S. A Mobile Intervention to Link Young Female Entertainment Workers in Cambodia to Health and Gender-Based Violence Services: Randomized Controlled Trial. J Med Internet Res 2022;24(1):e27696 DOI: 10.2196/27696

This study evaluated the efficacy of the Mobile Link intervention to improve female entertainment workers’ (FEW) health through engagement and connection to HIV, sexual and reproductive health, and gender-based violence services. In Cambodia, FEWs are employed at karaoke bars, restaurants, bars, and massage parlors and many exchange sex to supplement their income. Researchers conducted a randomized controlled trial in the capital city and 3 other regions in Cambodia with high numbers of FEWs and HIV prevalence. Eligible participants were aged 18-30 years, working as a FEW, sexually active, and owned a mobile phone. Participants were randomized to the Mobile Link intervention arm (n=218) or to the control arm (standard care; n=170). For 60 weeks, participants in the Mobile Link arm received automated twice-weekly text messages and voice messages with health information and direct links to community outreach workers. Outcomes included self-reported HIV and sexually transmitted infection (STI) testing, condom use, and contraceptive use at baseline and 6- and 12-month follow up. Results showed significant improvements in HIV and STI testing, condom use, and contraceptive use in both arms. The Mobile Link intervention was effective in connecting FEWs with outreach workers – contact increased by 61% in the intervention arm compared to a decrease of 30% in the control arm. Additionally, participants in the intervention arm reported significant reductions in forced drinking behavior at work from supervisors or peers compared to those in the control arm. Although there were no differences in the main outcomes, the Mobile Link intervention may be helpful in linking to outreach workers and could be potentially implemented among other populations in Cambodia, perhaps as an adjunct to standard care. Future research may consider using longer-term messaging to increase access to services and impact health outcomes.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ; ;
10/17/2022

Designing an electronic medical record alert to identify hospitalised patients with HIV: successes and challenges

El-Nahal W, Grader-Beck T, Gebo K, Holmes E, Herne K, Moore R, Thompson D, Berry S. Designing an electronic medical record alert to identify hospitalised patients with HIV: successes and challenges. BMJ Health Care Inform 2022;29:e100521. doi:10.1136/bmjhci-2021-100521

An electronic medical record (EMR) alert system was developed to use readily available data elements to accurately identify hospitalized people with HIV. Authors described the design and implementation of the EMR alert and methods to evaluate its accuracy for identifying people with HIV. Over 24 months, the EMR alert was used to notify an intervention team and data abstraction team in real time about admissions of people with HIV. Sensitivity was assessed by comparing the machine-learning alert system to manual chart reviews. Positive predictive value (probability that a patient with a positive test result actually has the disease), was assessed by false positives identified in chart review (not having HIV despite alert triggering). Results demonstrated high sensitivity (sensitivity=100%, 95% CI 82-100%) and good predictive value (84%, 95% CI 82-86%). A combination of data (diagnosis, prescriptions, and lab orders) in the EMR alert system achieved high sensitivity and positive predictive value in identifying people with HIV. ICD Code diagnoses were the strongest contributors to predictive value, compared to the other criteria. Use of data-driven alerts in electronic health record systems can facilitate the deployment of multidisciplinary teams for medication review, education, case management, and outpatient linkage to follow-up.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ;
09/05/2022

Effect of Digital Adherence Tools on Adherence to Antiretroviral Treatment Among Adults Living With HIV in Kilimanjaro, Tanzania: A Randomized Controlled Trial

Sumari-de Boer IM, Ngowi, KM, Sonda TB, Pima FM, Masika LV, Sprangers MAG, Reiss P, Mmbaga BT, Nieuwkerk PT, Aarnoutse RE. (2021). Effect of Digital Adherence Tools on Adherence to Antiretroviral Treatment Among Adults Living With HIV in Kilimanjaro, Tanzania: A Randomized Controlled Trial. JAIDS Journal of Acquired Immune Deficiency Syndromes, 87:5, 1136-1144, doi: 10.1097/QAI.0000000000002695

This study investigated two digital antiretroviral HIV treatment adherence interventions among adults with suboptimal adherence living in Kilimanjaro, Tanzania using a parallel 3-arm, non-blinded, randomized controlled trial with 1:1:1 allocation. In one arm, 80 participants received reminder text messages (SMS) on 3 random days a week. In the second arm, 82 participants received a real-time medication monitoring device (RTMM) called Wisepill with SMS reminders. The device contains antiretroviral treatment, and each opening is registered and sent to an Internet server. If participants do not open before the end of the dosage window, a text reminder is sent. In the third arm, 81 participants received treatment as usual according to Tanzanian guidelines (minimal adherence counseling by nurses or pharmacists and annual viral load test). Proportion of participants who have sufficient treatment adherence (>85% of doses) was collected at enrollment and every 8 weeks for 48 weeks (total of 7 timepoints) using pharmacy refill counts and self-report. Over 48 weeks, no significant difference in self-reported adherence was found between the three arms. The average adherence based on pharmacy refills was also not significantly different across the three arms. None of the intervention arms showed a significant effect on viral suppression rates. Overall, the study’s findings do not support the use of RTMM or SMS reminder cues as a means to significantly improve adherence to HIV treatment. The difference in pharmacy refill counts compared to self-reported adherence might be due to social desirability and overreporting in all arms. More research is needed to explore how digital interventions can be used to optimize adherence across risk groups, including children, youth, and pregnant or breastfeeding women.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ;
08/29/2022

Challenges and opportunities of telehealth digital equity to manage HIV and comorbidities for older persons living with HIV in New York State

Baim-Lance A, Angulo M, Chiasson MA, Lekas HM, Villarreal J, Cantos A, Kerr C, Nagaraja A, Yin MT, Gordon P. Challenges and opportunities of telehealth digital equity to manage HIV and comorbidities for older persons living with HIV in New York State. BMC Health Serv Res 22, 609 (2022). https://doi.org/10.1186/s12913-022-08010-5

This study used mixed methods to investigate access, use and quality of HIV and other telehealth services for older people living with HIV (PLWH) during the initial wave of the COVID-19 pandemic. Participants over 50 years of age and receiving HIV care in an urban academic medical center in New York City or in a rural federally qualified health center were enrolled (total N=80). The study administered a survey of closed and open-ended questions (in English or Spanish) in-person or via telephone. The survey assessed physical and mental health history and current health status, COVID-19 history, management of HIV and comorbidities during COVID-19, social support during COVID-19, and socio-demographics. Results found that telehealth access and use were impacted by several factors, including access to devices, connectivity, technology literacy, and privacy concerns. Seventy-four percent of participants had at least one telehealth visit for an HIV or specialty visit. Most (70%) participants who had at least one telehealth visit perceived it as worse than in-person. Specifically, participants felt the telehealth appointments were less interpersonal, prone to technical issues, and resulted in poorer outcomes (i.e., lack of receiving referrals and follow up care management). Reported barriers to telehealth included limited access to and reliability of technology, low technology literacy, and discomfort sharing with providers virtually. These findings inform the need for development of digital health interventions that are acceptable and feasible for older PLWH.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ; ;
08/23/2022

Implementation and impact of a technology-based HIV risk-reduction intervention among Thai men who have sex with men using “Vialogues”: a randomized controlled trial

Anand T, Nitpolprasert C, Jantarapakde J, Meksena R, Phomthong S, Phoseeta P, Phanuphak P & Phanuphak N (2020) Implementation and impact of a technology-based HIV risk-reduction intervention among Thai men who have sex with men using “Vialogues”: a randomized controlled trial, AIDS Care, 32:3, 394-405, DOI: 10.1080/09540121.2019.1622638

A randomized controlled trial was conducted to evaluate the impact of a technology-based intervention on HIV risks and condom use behaviors among men who have sex with men (MSM) in Thailand. Seventy-six participants who were at least 18 years of age and reported unprotected sex in the last 6 months were recruited from the Thai Red Cross Anonymous Clinic. Participants were randomly assigned to control (N=39) and intervention arms (N=37). The intervention group received HIV/STI prevention education videos delivered online via Vialogues.com and video sessions with a counselor monthly for 12 months. The control group received HIV counseling and testing alone for 12 months. Researchers compared attendance rates of recommended clinic visits and HIV testing, changes in HIV/AIDS knowledge, behavioral intentions, attitudes for engaging in safer sex, condom use self-efficacy, and risky behaviors at baseline, 6-month and 12-month follow-ups for both groups. Eighty-nine percent of participants in the intervention arm completed all monthly Vialogues sessions. At 12 months, participants in the intervention arm had significantly more clinic visits than those in the control arm (p=0.03). At 12 months, the intervention group also reported a significantly higher percentage of condom use for anal intercourse than the control group (p=0.003). Participants receiving the intervention also reported significantly reduced self-perceived HIV risk (p=0.001), popper use (p=0.002), and number of sexual partners (p=0.003), and increased condom use (p=0.006) from baseline to 6 months and 12 months. Results demonstrated that the Vialogues program was effective for improving safer sex behaviors and attitudes to lower HIV risk among Thai MSM.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ; ;
04/07/2022

Science Update: Digital Tool to Increase Youth HIV Testing Shows Promise in NIH-Funded Study

Article Excerpt: Youth aged 13 to 24 years who were offered HIV testing by a digital health tool on a tablet computer were as likely to accept as those who were offered testing face-to-face, according to a study funded by the National Institutes of Health. However, among study participants aged 19 and younger who previously declined HIV testing, those who used the digital tool were 1.7 times more likely to agree to an HIV test, compared to those who received a face-to-face offer. Findings from the study, which was conducted in a New York City hospital emergency department, appear in Cureus. The Mobile Augmented Screening tool, or MAS, was developed and evaluated with funding from NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development. Ian David Aronson, Ph.D., of Digital Health Empowerment and New York University, led the work.

Full Article: https://tinyurl.com/67nnmsu7

Article Source: NICHD

Posted in: Emerging Technologies // Tagged: ; ; ; ; ; ; ; ; ; ; ;