The Use of Cell Phone Support for Non-adherent HIV-Infected Youth and Young Adults: An Initial Randomized and Controlled Intervention Trial

This randomized behavioral trial examined whether youth living with HIV (YLH) receiving cell-phone support with study funded phone plans, demonstrated improved adherence and viral control during the 24 week intervention and 24 weeks post-intervention compared to controls. Monday through Friday phone calls confirmed medications were taken, provided problem-solving support, and referred to services to address adherence barriers. Of 37 participants (ages 15–24), 62 % were male and 70 % were African American. Self-reported adherence was significantly higher in the intervention group compared to the control at 24 and 48 weeks for the past month (P = 0.007) and log 10 HIV VL was significantly lower at both 24 weeks (2.82 versus 4.52 P = 0.002) and 48 weeks (3.23 versus 4.23 P = 0.043). Adherence and viral load showed medium to large effect sizes across the 48 week study. This is the first study to demonstrate sustained clinically significant reductions in HIV VL using youth friendly technology.ResumenEste ensayo de comportamiento aleatorio examinó si los jóvenes que viven con el VIH (YLH) reciben apoyo por celular con el estudio financiado de teléfono, se demostró un mejor cumplimiento y control viral durante la intervención de 24 semanas y 24 semanas después de la intervención en comparación con los controles. De Lunes a Viernes las llamadas telefónicas confirmaron los medicamentos, apoyaron la resolución de problemas, y se refirió a los servicios para hacer frente a las barreras de adherencia. De los 37 participantes (siglos 15–24), el 62 % eran hombres y el 70 % eran afroamericanos. Adherencia auto-reportada fue significativamente mayor en el grupo de intervención en comparación con el control a las 24 y 48 semanas del mes pasado (P = 0.007) y el log 10 VL VIH fue significativamente menor en ambos 24 semanas (2.82 versus 4.52 P = 0.002) y 48 semanas (3.23 versus 4.23 P = 0.043). La adhesión y la carga viral mostraron medianas y grandes tamaños del efecto en todo el estudio de 48 semanas. Este es el primer estudio que demuestra descensos importantes de la VL VIH utilizando tecnología amigable para la juventud.

[1]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[2]  P. Lachenbruch Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[3]  B. Everitt,et al.  Analysis of longitudinal data , 1998, British Journal of Psychiatry.

[4]  S. Swindells,et al.  Adherence of human immunodeficiency virus-infected patients to antiretroviral therapy. , 1999, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[5]  A. Moscicki,et al.  Barriers to HAART adherence among human immunodeficiency virus-infected adolescents. , 2003, Archives of pediatrics & adolescent medicine.

[6]  D. Swendeman,et al.  Use of HAART among young people living with HIV. , 2003, American journal of health behavior.

[7]  W. Steers,et al.  Predictors of antiretroviral adherence , 2004, AIDS care.

[8]  Marvin Belzer,et al.  The use of cell phone reminder calls for assisting HIV-infected adolescents and young adults to adhere to highly active antiretroviral therapy: a pilot study. , 2006, AIDS patient care and STDs.

[9]  S. Coleman,et al.  The provider role in client engagement in HIV care. , 2007, AIDS patient care and STDs.

[10]  Scott R. Smith,et al.  Telephone Support to Improve Antiretroviral Medication Adherence: A Multisite, Randomized Controlled Trial , 2008, Journal of acquired immune deficiency syndromes.

[11]  K. Cummings,et al.  The Past , Present , and Future of HIV Prevention : Integrating Behavioral , Biomedical , and Structural Intervention Strategies for the Next Generation of HIV Prevention , 2009 .

[12]  D. Harris,et al.  Improving health outcomes for youth living with the human immunodeficiency virus: a multisite randomized trial of a motivational intervention targeting multiple risk behaviors. , 2009, Archives of pediatrics & adolescent medicine.

[13]  B. Fjeldsoe,et al.  Behavior change interventions delivered by mobile telephone short-message service. , 2009, American journal of preventive medicine.

[14]  W. Jack,et al.  Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial , 2010, The Lancet.

[15]  H. Cole-Lewis,et al.  Text messaging as a tool for behavior change in disease prevention and management. , 2010, Epidemiologic reviews.

[16]  Sylvie Naar-King,et al.  Predictors of medication adherence in high risk youth of color living with HIV. , 2010, Journal of pediatric psychology.

[17]  J. Fitzpatrick,et al.  Social Support and Adherence: Differences Among Clients in an AIDS Day Health Care Program , 2010, The Journal of the Association of Nurses in AIDS Care : JANAC.

[18]  Chengcheng Hu,et al.  Directly observed therapy (DOT) for nonadherent HIV-infected youth: lessons learned, challenges ahead. , 2010, AIDS research and human retroviruses.

[19]  S. Spector,et al.  Psychological factors, beliefs about medication, and adherence of youth with human immunodeficiency virus in a multisite directly observed therapy pilot study. , 2011, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[20]  Cristian Pop-Eleches,et al.  Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders , 2011, AIDS.

[21]  Michael Rayment,et al.  Prevention of HIV-1 infection with early antiretroviral therapy , 2012, Journal of Family Planning and Reproductive Health Care.

[22]  Robert Garofalo,et al.  Improving Adherence to Antiretroviral Therapy for Youth Living with HIV/AIDS: A Pilot Study Using Personalized, Interactive, Daily Text Message Reminders , 2012, Journal of medical Internet research.

[23]  Sylvie Naar-King,et al.  Barriers to Medication Adherence in Behaviorally and Perinatally Infected Youth Living with HIV , 2012, AIDS and Behavior.