A Pilot Study of a Mobile App to Support HIV Antiretroviral Therapy Adherence Among Men Who Have Sex with Men Who Use Stimulants
APP+ is a theoretically-grounded mobile app intervention to improve antiretroviral (ART) adherence among men who have sex with men (MSM) who use stimulants. We assessed the feasibility and acceptability of APP+ in a six-month randomized controlled trial among a national sample of 90 MSM recruited online; secondarily, we examined changes in self-reported ART adherence by study arm. Retention at the final assessment was 82%, and acceptability ratings were comparable to other technology-based interventions. MSM in the APP+ group reported higher self-reported percentage ART adherence in the past 30 days at the four-month timepoint compared to a no-treatment control group (89.0% vs. 77.2%). However, once access to the app was removed after month four, group differences in ART adherence diminished by month six. APP+ may be a potentially promising intervention approach for MSM living with HIV who use stimulants but would require enhancements to optimize acceptability and demonstrate more sustained effects.
KeywordsHIV/AIDS Medication adherence Drug use Mobile app
We would like to thank participants for the time they offered during the conduct of this study. Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number R34DA033833. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
- 1.Centers for Disease Control and Prevention. HIV surveillance report, 2017; vol. 29 2018. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2017-vol-29.pdf. Accessed 13 July 2019.
- 3.Mathers BM, Degenhardt L, Phillips B, Wiessing L, Hickman M, Strathdee SA, et al. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. The Lancet. 9651;372:1733–45.Google Scholar
- 10.National Institute on Drug Abuse. Commonly abused drugs charts. https://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts. Accessed 13 July 2019.
- 12.Forrest DW, Metsch LR, LaLota M, Cardenas G, Beck DW, Jeanty Y. Crystal methamphetamine use and sexual risk behaviors among HIV-positive and HIV-negative men who have sex with men in South Florida. J Urban Health: Bull N Y Acad Med. 2010;87(3):480–5.Google Scholar
- 21.Centers for Disease Control and Prevention. Compendium of evidence-based HIV behavioral interventions: medication adherence chapter: CDC; 2017. https://www.cdc.gov/hiv/research/interventionresearch/compendium/ma/index.html. Accessed 13 July 2019.
- 23.Johnson MO, Charlebois E, Morin SF, Remien RH, Chesney MA. Effects of a behavioral intervention on antiretroviral medication adherence among people living with HIV: the healthy living project randomized controlled study. J Acquir Immune Defic Syndr. 2007;46(5):574–80.PubMedPubMedCentralGoogle Scholar
- 32.Glasner-Edwards S, Patrick K, Ybarra ML, Reback CJ, Rawson RA, Chokron Garneau H, et al. A cognitive behavioral therapy-based text messaging intervention versus medical management for HIV-infected substance users: study protocol for a pilot randomized trial. JMIR Res Protoc. 2016;5(2):e131.PubMedPubMedCentralGoogle Scholar
- 39.Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1992;1:385–401.Google Scholar
- 44.The LifeWindows Project Team. The LifeWindows information motivation behavioral skills ART adherence questionnaire (LW-IMB-AAQ). Storrs: University of Connecticut: Center for Health, Intervention, and Prevention; 2006.Google Scholar
- 45.Brook J. A quick and dirty usability scale. In: Jordan PW, Thomas B, Weerdmeester BA, McClellend, editors. Usability Evaluation in industry. London: Taylor Francis; 1996.Google Scholar
- 47.Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996;276(8):637–9.Google Scholar
- 49.Walters SJ, Bonacho dos Anjos Henriques-Cadby I, Bortolami O, Flight L, Hind D, Jacques RM, et al. Recruitment and retention of participants in randomised controlled trials: a review of trials funded and published by the United Kingdom Health Technology Assessment Programme. BMJ Open. 2017;7(3):76.Google Scholar
- 53.Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2016. 2017 June 2018.Google Scholar
- 54.Centers for Disease Control and Prevention. HIV surveillance report, 2016. 2017 March 21, 2018.Google Scholar
- 56.U.S. Deptartment of Health and Human Services. Usability Testing. http://www.usability.gov/how-to-and-tools/methods/usability-testing.html. Accessed 13 July 2019.
- 59.Guarino H, Acosta M, Marsch LA, Xie H, Aponte-Melendez Y. A mixed-methods evaluation of the feasibility, acceptability, and preliminary efficacy of a mobile intervention for methadone maintenance clients. Psychol Addict Behav: J Soc Psychol Addict Behav. 2016;30(1):1–11.Google Scholar
- 61.Marlatt GA. Harm reduction: pragmatic strategies for managing high-risk behaviors. New York: Guilford Press; 1998.Google Scholar
- 64.Sewell J, Cambiano V, Miltz A, Speakman A, Lampe FC, Phillips A, et al. Changes in recreational drug use, drug use associated with chemsex, and HIV-related behaviours, among HIV-negative men who have sex with men in London and Brighton, 2013–2016. Sex Transm Infect. 2018;94:494–501.PubMedPubMedCentralGoogle Scholar