Abstract
Purpose: Adolescents and Young Adults account for nearly 40% of new HIV infections each year and are significantly less likely than their adult counterparts to achieve viral suppression. Individuals living with chronic disease like HIV spend approximately 5,000 waking hours per year outside the doctor’s office in which they make health behavior decisions. Youth constantly consume mobile technology which represents a tremendous opportunity to provide support for adherence to HIV+ youth in the real places and times they need it as they go about their daily lives. The purpose of this study was to (1) understand frequency and patterns of mobile phone and social media use among youth living with HIV and (2) determine youth preferences for a mobile phone based application targeted at improving medication adherence and reducing sexual risk behavior. Methods: The study employed a mixed methods design including (1) a Computer-Assisted Self-Interview (CASI) administered via REDCap on an iPad to determine mobile phone and social media use patterns and frequency and (2) two focus groups were conducted using nominal group technique to determine youth preferences for app features. Participants were asked to list features of a mobile phone app that they felt would be most helpful to increase medication adherence and reduce sexual risk behavior. They were then shown wireframes (drawings of the design, flow, and features) of a potential app developed by the multidisciplinary study team based on their clinical experience including game/app designers, an adolescent medicine physician who provides care for youth living with HIV, and an HIV+ young adult. Finally they were asked to rank the most important feature from their suggestions and those presented by the study team. Results: N1⁄410. Mean age was 21. Participants were 90% male, 80% African American, 60% Android users, and on average spent 13.7 hours per day on their smartphones. The key features identified in the 2 focus groups were (1) medication reminders, (2) a calendar showing adherence progress, (3) panic button, (4) resources and information on medication, housing, insurance, (5) STI testing and condom locator, (6) gaming functions including avatars and team support, (7) message boards and personal stories, (8) pill cam, (9) daily fun facts or inspiringmessages, and (10) direct link tomedical provider. Conclusions: HIV+ youth consume mobile technology frequently and identified key features for a potential mHealth secondary prevention intervention. Next steps include professional app development, usability testing, and a 3-month pilot feasibility trial that will collect data on satisfaction, usage, adherence to medication and other care outcomes. Sources of Support: NIH K23MH102128-01A1 (Dowshen); University of Pennsylvania Center for AIDS Research Pilot Award P30AI45008 (Hoxie). 155.
Published Version
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