Abstract
BackgroundIn the United States, adolescents and young adults are disproportionately affected by HIV and have poorer HIV-related health outcomes than adults. Health care transition (HCT) from pediatric or adolescent to adult-oriented HIV care is associated with disruptions to youths’ care retention, medication adherence, and viral suppression. However, no evidence-based interventions exist to improve HCT outcomes for youth living with HIV.ObjectiveThere are 2 phases of this project. Phase 1 involves the iterative development and usability testing of a Social Cognitive Theory–based mobile health (mHealth) HIV HCT intervention (iTransition). In phase 2, we will conduct a pilot implementation trial to assess iTransition’s feasibility and acceptability and to establish preliminary efficacy among youth and provider participants.MethodsThe iterative phase 1 development process will involve in-person and virtual meetings and a design team comprising youth living with HIV and health care providers. The design team will both inform the content and provide feedback on the look, feel, and process of the iTransition intervention. In phase 2, we will recruit 100 transition-eligible youth across two clinical sites in Atlanta, Georgia, and Philadelphia, Pennsylvania, to participate in the historical control group (n=50; data collection only) or the intervention group (n=50) in a pilot implementation trial. We will also recruit 28 provider participants across the pediatric or adolescent and adult clinics at the two sites. Data collection will include electronic medical chart abstraction for clinical outcomes as well as surveys and interviews related to demographic and behavioral characteristics; Social Cognitive Theory constructs; and intervention feasibility, acceptability, and use. Analyses will compare historical control and intervention groups in terms of HCT outcomes, including adult care linkage (primary), care retention, and viral suppression (secondary). Interview data will be analyzed using content analysis to understand the experience with use and acceptability.ResultsPhase 1 (development) of iTransition research activities began in November 2019 and is ongoing. The data collection for the phase 2 pilot implementation trial is expected to be completed in January 2023. Final results are anticipated in summer 2023.ConclusionsThe development and pilot implementation trial of the iTransition intervention will fill an important gap in understanding the role of mHealth interventions to support HCT outcomes for youth living with HIV.International Registered Report Identifier (IRRID)DERR1-10.2196/24565
Highlights
Adolescents and young adults are disproportionately affected by HIV in the United States compared with their adult counterparts [1]
Phase 1 of iTransition research activities began in November 2019 and is ongoing
Final results are anticipated in summer 2023
Summary
Adolescents and young adults are disproportionately affected by HIV in the United States compared with their adult counterparts [1]. Recent research suggests that only 43% of youth living with HIV have received any HIV medical care and that only 33% are virally suppressed [1] These challenges are accentuated during the health care transition (HCT) from pediatric or adolescent to adult-oriented care [2,3]. In the United States, HIV-related HCT typically occurs around the age of 24 years [5] and is often associated with disruptions to care retention, medication adherence, and viral suppression [6]. In the United States, adolescents and young adults are disproportionately affected by HIV and have poorer HIV-related health outcomes than adults. Health care transition (HCT) from pediatric or adolescent to adult-oriented HIV care is associated with disruptions to youths’ care retention, medication adherence, and viral suppression. No evidence-based interventions exist to improve HCT outcomes for youth living with HIV
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