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

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Abstract

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.

Resumen

Este 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.

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Acknowledgments

This work was supported by The Adolescent Trials Network for HIV/AIDS Interventions (ATN; 5U01-HD 40533 and 5 UO1 HD 40474) from the National Institutes of Health through the National Institute of Child Health and Human Development (B. Kapogiannis, S. Lee), with supplemental funding from the National Institutes of Drug Abuse (S. Kahana) and Mental Health (P. Brouwers, S. Allison). The study was scientifically reviewed by the ATN’s Behavioral Leadership Group. Network, scientific, and logistical support was provided by the ATN Coordinating Center (C. Wilson, C. Partlow) at the University of Alabama at Birmingham. Network operations and data management support was provided by the ATN Data and Operations Center at Westat, Inc. (J. Korelitz, B. Driver). We acknowledge the contribution of the investigators and staff at the following ATN 078 sites that participated in this study: Children’s Hospital of Los Angeles (Marvin Belzer, M.D., Julie McAvoy-Banerjea, MPH, Michelle Bradford, B.A.); Children’s National Medical Center (Lawrence D’Angelo, M.D., Connie Trexler, RN, Amanda Terry, BS); University of California, San Francisco (Barbara Moscicki, M.D., Lisa Irish, B.S.N., Nigel R. Reyes, BFA); Tulane Medical Center (Sue Ellen Abdalian, M.D., Brenda H Andrews, MSN, Heather J. Ray, BS); Children’s Diagnostic & Treatment Center (Ana Puga, M.D., Amy Inman, BS, James S. Blood, MSW); We sincerely thank the ATN 078 Protocol Team Members (Steven Asch, M.D., Aditya Gaur, M.D., Sue Ellen Abdalian, M.D., Esmine Leonard, BSN, Trina Jeanjacques, BA, Catherine Forbes, PhD), the ATN Community Advisory Board, and the youth who participated in the study. An oral presentation of portions of this study was made at the bi-annual Adolescent Medicine Trials Network for HIV/AIDS Intervention Meeting in Bethesda, MD, on October 2, 2012. The views and opinions expressed in this report are those of the authors and should not be construed to represent the views of NIDA or any of the sponsoring organizations, agencies, or the US government.

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Authors and Affiliations

  1. Department of Pediatrics, Children’s Hospital Los Angeles and University of Southern California, 4650 Sunset Blvd MS#2, Los Angels, CA, 90027, USA

    Marvin E. Belzer, Johanna Olson & Leslie F. Clark

  2. Pediatric Prevention Center, Wayne State University, Detroit, MI, USA

    Sylvie Naar-King

  3. Westat, Rockville, MD, USA

    Moussa Sarr & Sarah Thornton

  4. NIDA, Bethesda, MD, USA

    Shoshana Y. Kahana

  5. Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Aditya H. Gaur

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  1. Marvin E. Belzer
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  2. Sylvie Naar-King
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  3. Johanna Olson
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  4. Moussa Sarr
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  5. Sarah Thornton
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  6. Shoshana Y. Kahana
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  7. Aditya H. Gaur
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  8. Leslie F. Clark
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The Adolescent Medicine Trials Network for HIV/AIDS Interventions

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Correspondence to Marvin E. Belzer.

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Belzer, M.E., Naar-King, S., Olson, J. et al. The Use of Cell Phone Support for Non-adherent HIV-Infected Youth and Young Adults: An Initial Randomized and Controlled Intervention Trial. AIDS Behav 18, 686–696 (2014). https://doi.org/10.1007/s10461-013-0661-3

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