Use of an mHealth Intervention to Improve Engagement in HIV Community-Based Care Among Persons Recently Released from a Correctional Facility in Washington, DC: A Pilot Study

• Published in: AIDS and behavior Vol. 23; no. 4; pp. 1016 - 1031
• Main Authors: Kuo, Irene, Liu, Tao, Patrick, Rudy, Trezza, Claudia, Bazerman, Lauri, Uhrig Castonguay, Breana J., Peterson, James, Kurth, Ann, Beckwith, Curt G.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.04.2019; Springer Nature B.V
• Subjects: Adult; Anti-Retroviral Agents - therapeutic use; Antiretroviral drugs; Antiretroviral therapy; Community health care; Correctional institutions; Counseling; Criminals; Delivery of Health Care; Disease management; District of Columbia; Female; Health Psychology; Health services; HIV; HIV Infections - drug therapy; HIV Infections - psychology; HIV Infections - virology; Human immunodeficiency virus; Humans; Imprisonment; Infectious Diseases; Intervention; Male; Medical personnel; Medication Adherence; Medicine; Medicine & Public Health; Middle Aged; Multivariable control; Original Paper; Pilot Projects; Prisons; Public Health; Random effects; Reentry; Retention in Care; Short message service; Statistical analysis; Telemedicine; Text Messaging; Transgender persons; Transsexuality; Viral Load; District of Columbia; Washington DC; United States > US; mHealth; Engagement in care; HIV; Incarcerated persons
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-018-02389-1

We examined the preliminary effectiveness of a computerized counseling session plus post-incarceration text messaging intervention (CARE + Corrections) to support ART adherence and linkage/engagement in community care among recently incarcerated persons with HIV in Washington, D.C. Recently incarcerated persons with HIV ≥ 18 years old were recruited from the D.C. jail or community outreach and randomized to CARE + Corrections or control arm. Participants completed assessments at baseline, 3-months and 6-months. Multivariable random effects modeling identified predictors of suppressed viral load (≤ 200 copies/mL) and engagement in HIV care at 6 months. Participants (N = 110) were aged 42 (IQR 30–49); 58% male, 24% female, 18% transgender, 85% Black, and lifetime incarceration was a median of 7 years (IQR 2–15). More controls had a regular healthcare provider at baseline. Although not statistically significant, intervention participants had increased odds of viral suppression versus controls at 6 months (AOR 2.04; 95% CI 0.62, 6.70). Those reporting high ART adherence at baseline had higher odds of viral suppression at follow-up (AOR 10.77; 95% CI 1.83, 63.31). HIV care engagement was similar between the two groups, although both groups reported increased engagement at 6 months versus baseline. We observed a positive but non-significant association of viral suppression in the CARE + Corrections group, and care engagement increased in both groups after 6 months. Further attention to increasing viral suppression among CJ-involved persons with HIV upon community reentry is warranted.