Youth and Antiretroviral Therapy

Comprehensive, tailored, technology-based intervention to improve virologic suppression among youth and young adults living with HIV

Investigators: Parya Saberi, Mallory Johnson, Tor Neilands, Valerie Gruber, Caravella McCuistian, Marie Stoner (RTI), Celeste Balaban, Kristin Ming, Louis Smith

In the US, young adults with HIV (YWH) have lower rates of antiretroviral therapy (ART) initiation, suboptimal ART adherence and retention in care, and higher rates of virologic failure, compared to older age groups. Additionally, there is an increased risk of substance dependence, psychiatric disorders, and mortality with increased risk of substance use at a younger age. Mental health (MH) and substance use (SU) impact every step of the HIV care continuum from diagnosis to viral suppression and exacerbate socioeconomic challenges of linkage and sustained access to healthcare.

In collaboration with the nonprofit AIDS Healthcare Foundation (the largest provider of HIV care) and a Youth Advisory Panel, Parya Saberi and her team propose to address these barriers by implementing an entirely remotely-conducted randomized clinical trial (RCT) study among 200 YWH (18–29 years old where home-based viral load testing will be conducted at baseline, 16, 32, and 48 weeks using a Hemaspot device.

This tailored technology-based intervention with the use of an adaptive treatment strategy (ATS) will 1) test the efficacy of video-counseling+app vs standard of care on virologic suppression, 2) assess the impact of video-counseling+app vs standard of care on MH and SU, and 3) explore ATS to individualize the intervention.

Given the severe shortages of MH providers when MH and SU challenges of YWH are critical barriers to care, this innovative intervention grounded in a well-established theoretical model of care and formative research, and with community partnership is critical to the U.S. “getting to zero” and ending the HIV epidemic.

Article - https://bmjopen.bmj.com/content/13/10/e077676  iVY: protocol for a randomised clinical trial to test the effect of a technology-based intervention to improve virological suppression among young adults with HIV in the USA. (P Saberi, C Balaban, K Ming, L Smith, T Neilands, M Johnson (CAPS/PRC)