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This study applies Social Cognitive Theory to develop behavioral interventions promoting PrEP adherence. It seeks to adapt and test the enhanced HMP app for feasibility and acceptability among Black adolescents and young adults (AYAs) and adult supports.
HIV pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV infections, reducing the risk by over 90%. However, adherence among AYAs remains suboptimal, with only 34% maintaining adherence at 48 weeks. Studies suggest that adult support can improve adherence in pediatric HIV treatment, but this approach has not been systematically evaluated for PrEP use in AYAs. Prior research indicates that Black AYAs and their families are open to incorporating adult support for PrEP adherence. Given the success of mobile health (mHealth) interventions in promoting sexual health, this study aims to enhance the HealthMPowerment (HMP) app-an existing mHealth platform designed for HIV prevention-to facilitate dyadic communication between Black AYAs and trusted adult support persons.
The study addresses the high rates of HIV among Black adolescents and young adults (AYAs) in metro Atlanta, Georgia, where AYAs (ages 13-24) account for 21% of new HIV diagnoses, with Black gay and bisexual males, transgender individuals, and heterosexual young women being disproportionately affected. Nearly half of new infections occur in rural areas. The U.S. Department of Health and Human Services Ending the HIV Epidemic initiative prioritizes four counties in metro Atlanta (Cobb, DeKalb, Fulton, and Gwinnett) as geographic hotspots, emphasizing the need for patient-centered interventions to reduce HIV incidence.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AYA group | Experimental | All enrolled participants (AYAs and support persons) will receive a demonstration of the app, including all of its features. All participants will use the app for 6 months. Each dyad of participants will be instructed to use the app to communicate with each other and AYAs will be instructed to use the app to keep track of their PrEP. Data from the medication tracker will be collected at 1-, 3-, and 6-months |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Health MPowerment App | Behavioral | A mobile health app designed to facilitate increased PrEP use and adherence among AYAs |
|
| Measure | Description | Time Frame |
|---|---|---|
| Acceptability/Usability | The study evaluates an app's impact through post-intervention interviews, focusing on user experience, ethical concerns, and future usage intentions. It explores burden, satisfaction, attitudes, and how the app influences communication and adherence. Sekhon's Theoretical Framework of Acceptability will be utilized to measure this outcome. | 1 month, 3 months, and 6 months |
| Feasibility: Communication | Communication between adolescents and young adults (AYA) and support person (i.e., Experience using chat features; Experience using forums). A modified version of Structured Assessment of FEasibility (SAFE) will be utilized to measure this outcome. | 1 month, 3 months, and 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Medication Adherence Tracker | This will be measured by analyzing the percent of dates with data entered into the medication tracker and correlating that data with reasons why participants did not take their medication (when applicable) | 1 month, 3 months, and 6 months |
| Data Usage |
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Inclusion Criteria:
Exclusion Criteria:
HIV positive Inability to provide consent
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Samantha Hill, MD, MPH | Contact | 404-778-1537 | samantha.veronica.hill@emory.edu | |
| Jacob Aiello, MPH | Contact | 404-712-9344 | jacob.aiello@emory.edu |
| Name | Affiliation | Role |
|---|---|---|
| Samantha Hill, MD, MPH | Emory University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Emory University | Atlanta | Georgia | 30322 | United States |
The following data will be shared: Data acceptability and feasibility measures as analyzed via interviews and surveys, and data app usage
May 2027 onwards
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| ID | Term |
|---|---|
| D015658 | HIV Infections |
| D055118 | Medication Adherence |
| ID | Term |
|---|---|
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D015229 | Sexually Transmitted Diseases, Viral |
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AYAs will be paired with an adult who has identified as a support person and will use the app to facilitate dyadic communication to improve PrEP use among Black AYAs. Participants will be enrolled for 6 months. All participants will participate in the intervention
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This will be measured by comparing the amount of time (minutes) spent using distinct features of the app (e.g. forums, educational resources, avatars, side effect trackers, chat features) |
| 1 month, 3 months, and 6 months |
| D012749 | Sexually Transmitted Diseases |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |
| D010349 | Patient Compliance |
| D010342 | Patient Acceptance of Health Care |
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
| D001519 | Behavior |