Abstract

BackgroundAmong persons living with HIV, poorer antiretroviral therapy adherence has been reported in African Americans and disproportionate mortality reported in young African American men who have sex with men (AAMSM) compared to whites. We report the results of focus groups with young AAMSM living with HIV that explore their opinions about the acceptability and feasibility of a triaged real-time missed dose alert intervention to improve treatment adherence.The purpose of this study is to develop a theory-driven triaged real-time adherence monitoring intervention to promote HIV medication adherence in young AAMSM.MethodsWe performed five focus groups and two individual interviews among young HIV-positive AAMSM (n = 25) in Chicago guided by the Technology Acceptance Model and explored perceptions regarding the monitoring concept including device issues and concerns about inclusion of support persons whose involvement is triggered by sustained missed doses. The purpose was to inform the development of this intervention in this population.ResultsGenerally, the participants found the proposed intervention acceptable and useful. Privacy was a major concern for participants especially with attention to possible disclosure of their HIV status by receiving a medication-related text that someone else might view and could lead to unwanted attention. There was concern that the device could be confused with a taser. Approximately half of the men already had a close personal contact that helped them with medication taking. Some participants acknowledged that the notification might lead to friction.ConclusionsA triaged real-time alert intervention to improve treatment adherence is acceptable and feasible among young AAMSM living with HIV.

Highlights

  • Young African American men who have sex with men (AAMSM) are disproportionately impacted by new HIV infections and HIV-related mortality [1,2,3,4,5]

  • Better adherence has been observed with newer regimens of antiretroviral therapy (ART) compared to the first decade of highly active ART [6,7,8,9,10,11,12,13], racial disparities exist with several studies demonstrating poorer adherence among African Americans compared to whites [14,15,16,17,18,19,20]

  • Intervention We propose an intervention to improve ART adherence for young AAMSM living with HIV that employs a triaged approach, utilizes real-time adherence monitoring, and leverages existing social support

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Summary

Introduction

Young African American men who have sex with men (AAMSM) are disproportionately impacted by new HIV infections and HIV-related mortality [1,2,3,4,5]. Among persons living with HIV, poorer antiretroviral therapy adherence has been reported in African Americans and disproportionate mortality reported in young African American men who have sex with men (AAMSM) compared to whites. We report the results of focus groups with young AAMSM living with HIV that explore their opinions about the acceptability and feasibility of a triaged real-time missed dose alert intervention to improve treatment adherence.

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