A triaged real-time alert intervention to improve antiretroviral therapy adherence among young African American men who have sex with men living with HIV: focus group findings

• Published in: BMC public health Vol. 19; no. 1; pp. 394 - 11
• Main Authors: Dworkin, Mark S, Panchal, Palak, Wiebel, Wayne, Garofalo, Robert, Haberer, Jessica E, Jimenez, Antonio
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11.04.2019; BioMed Central; BMC
• Subjects: Acceptability; Acquired immune deficiency syndrome; Adherence; Adhesion; Adult; African Americans; AIDS; Anti-Retroviral Agents - therapeutic use; Antiretroviral; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Black or African American - psychology; Care and treatment; Chicago; Control; Disclosure of information; Disease transmission; Feasibility; Focus Groups; Gays & lesbians; Health aspects; Highly active antiretroviral therapy; HIV; HIV infections; HIV Infections - drug therapy; HIV Infections - psychology; HIV Infections - virology; HIV patients; Homosexuality, Male; Human immunodeficiency virus; Humans; Intervention; Male; Medication Adherence - psychology; Men who have sex with men; Mens health; Middle Aged; Monitoring; Mortality; MSM (Men who have sex with men); Patient compliance; Patient outcomes; Public health; Qualitative research; Real time; Sexual and Gender Minorities - psychology; Sexually transmitted diseases; Social aspects; Social support; STD; Technology; Technology utilization; Therapy; Triage - methods; Wisepill; Young Adult; Chicago; Uganda; Chicago Illinois; United States > US; China; Adherence; Text message; HIV; Real-time; Men who have sex with men; Antiretroviral; Wisepill; Monitoring
• DOI: 10.1186/s12889-019-6689-1
• ISSN: 1471-2458

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. 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. We 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. Generally, 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. A triaged real-time alert intervention to improve treatment adherence is acceptable and feasible among young AAMSM living with HIV.