Technology Based Community Health Nursing to Improve Combination Anti-Retroviral Therapy (cART) Adherence and Virologic Suppression in Youth Living With HIV
| Status: | Recruiting |
|---|---|
| Conditions: | HIV / AIDS |
| Therapuetic Areas: | Immunology / Infectious Diseases |
| Healthy: | No |
| Age Range: | 12 - 25 |
| Updated: | 11/4/2018 |
| Start Date: | July 11, 2018 |
| End Date: | June 1, 2022 |
| Contact: | Allison Agwu, MD, ScM |
| Email: | ageorg10@jhmi.edu |
| Phone: | 410-614-3917 |
Technology Based Community Health Nursing to Improve cART Adherence and Virologic Suppression in Youth Living With HIV (TECH-N 2 CHECK-IN): A Regional Multi-site Study
Human immunodeficiency virus (HIV) infection has disproportionately persisted as a public
health threat to adolescents and young adults (AYA) from minority communities in the United
States. HIV has evolved into a chronic disease, which can be managed in the outpatient
setting with antiretroviral therapy (ART) designed to achieve virologic suppression and life
expectancy equivalent for uninfected individuals. Community health nurse (CHN) interventions
have been shown to increase access to appropriate resources, enhance health care utilization,
and promote risk-reducing behavior among AYA. Use of short messaging service (SMS) messaging
can further enhance clinical care by improving attendance at medical visits, medication
adherence, and communication with the health care team.Investigators have used these two
modalities in randomized trials of youth with complex sexually transmitted infections (STIs)
in low-income minority communities with high feasibility and acceptability amongst AYA and
families, remarkable improvements in visit completion, medication adherence, and reduction in
recurrent STIs. The overarching goal of this project is to build on the evidence from this
trial and to re-purpose the intervention for Young people Living with HIV (YLHIV) in the same
community who are having challenges with care and medication non-adherence.Investigators aim
to compare the effectiveness of a technology-enhanced community health nursing intervention
(TECH2CHECK) to a standard of care control group using a randomized trial design. The central
hypothesis is that the intervention will result in higher rates of adherence to ART and
virologic suppression. Investigators have demonstrated investigators' interdisciplinary
team's capacity to follow urban AYA in the community, utilizing the combination of CHNs and
outreach workers to optimize care according to national standards. TECH2CHECK aims to enroll
120 YLHIV followed at clinics specializing in HIV care in the Baltimore-Washington
Metropolitan area who are challenged with treatment adherence and randomizing participants to
receive TECH2CHECK vs. standard of care. Results of this trial will inform best practices for
engaging YLHIV by addressing the distal component of the continuum, critical to achieving the
elusive 90-90-90 HIV goals.
health threat to adolescents and young adults (AYA) from minority communities in the United
States. HIV has evolved into a chronic disease, which can be managed in the outpatient
setting with antiretroviral therapy (ART) designed to achieve virologic suppression and life
expectancy equivalent for uninfected individuals. Community health nurse (CHN) interventions
have been shown to increase access to appropriate resources, enhance health care utilization,
and promote risk-reducing behavior among AYA. Use of short messaging service (SMS) messaging
can further enhance clinical care by improving attendance at medical visits, medication
adherence, and communication with the health care team.Investigators have used these two
modalities in randomized trials of youth with complex sexually transmitted infections (STIs)
in low-income minority communities with high feasibility and acceptability amongst AYA and
families, remarkable improvements in visit completion, medication adherence, and reduction in
recurrent STIs. The overarching goal of this project is to build on the evidence from this
trial and to re-purpose the intervention for Young people Living with HIV (YLHIV) in the same
community who are having challenges with care and medication non-adherence.Investigators aim
to compare the effectiveness of a technology-enhanced community health nursing intervention
(TECH2CHECK) to a standard of care control group using a randomized trial design. The central
hypothesis is that the intervention will result in higher rates of adherence to ART and
virologic suppression. Investigators have demonstrated investigators' interdisciplinary
team's capacity to follow urban AYA in the community, utilizing the combination of CHNs and
outreach workers to optimize care according to national standards. TECH2CHECK aims to enroll
120 YLHIV followed at clinics specializing in HIV care in the Baltimore-Washington
Metropolitan area who are challenged with treatment adherence and randomizing participants to
receive TECH2CHECK vs. standard of care. Results of this trial will inform best practices for
engaging YLHIV by addressing the distal component of the continuum, critical to achieving the
elusive 90-90-90 HIV goals.
Inclusion Criteria:
- Eligible participants should be aged 12-25 years old diagnosed with HIV
- Eligible for ART, VL>20 copies/ml
- English speaking (>95% current clinic population)
- aware of their HIV status
- Permanently reside in the Baltimore or Washington Metropolitan area
- Willing to sign informed consent (including allowing communication with the
participant's primary care provider). Informed consent includes being willing to
complete study procedures; including randomization and community-based follow-up by
our team.
Exclusion Criteria:
- Mental health, cognitive, or behavioral dysfunction that in the opinion of the site PI
would impair effective participation
- Severe illness requiring hospitalization at the time of enrollment. This will be
assessed at the team meetings designed to generate referrals.
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