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A virtual pilot optimization trial for African American/Black and Latino persons with non-suppressed HIV viral load grounded in motivational interviewing and behavioral economics.
Filippone, Prema; Serrano, Samantha; Gwadz, Marya; Cleland, Charles M; Freeman, Robin; Linnemayr, Sebastian; Cluesman, Sabrina R; Campos, Stephanie; Rosmarin-DeStefano, Corey; Amos, Brianna; Israel, Khadija.
Afiliación
  • Filippone P; Intervention Innovations Team Lab (IIT-Lab), New York University Silver School of Social Work, New York, NY, United States.
  • Serrano S; Center for Drug Use and HIV Research, School of Global Public Health, New York University, New York, NY, United States.
  • Gwadz M; Intervention Innovations Team Lab (IIT-Lab), New York University Silver School of Social Work, New York, NY, United States.
  • Cleland CM; Intervention Innovations Team Lab (IIT-Lab), New York University Silver School of Social Work, New York, NY, United States.
  • Freeman R; Center for Drug Use and HIV Research, School of Global Public Health, New York University, New York, NY, United States.
  • Linnemayr S; Center for Drug Use and HIV Research, School of Global Public Health, New York University, New York, NY, United States.
  • Cluesman SR; Division of Biostatistics, Department of Population Health, New York University School of Medicine, New York, NY, United States.
  • Campos S; Independent Consultant, New York, NY, United States.
  • Rosmarin-DeStefano C; Pardee RAND Graduate School, Santa Monica, CA, United States.
  • Amos B; Intervention Innovations Team Lab (IIT-Lab), New York University Silver School of Social Work, New York, NY, United States.
  • Israel K; Independent Consultant, New York, NY, United States.
Front Public Health ; 11: 1167104, 2023.
Article en En | MEDLINE | ID: mdl-37234760
Introduction: Virtual and low-touch behavioral interventions are needed for African American/Black and Latino persons living with HIV (PLWH) with barriers to HIV viral suppression, particularly during COVID-19. Guided by the multiphase optimization strategy, we explored three components for PLWH without viral suppression, grounded in motivational interviewing and behavioral economics: (1) motivational interviewing counseling, (2) 21-weeks of automated text messages and quiz questions about HIV management, and (3) financial rewards for viral suppression (lottery prize vs. fixed compensation). Methods: This pilot optimization trial used sequential explanatory mixed methods to explore the components' feasibility, acceptability, and preliminary evidence of effects using an efficient factorial design. The primary outcome was viral suppression. Participants engaged in baseline and two structured follow-up assessments over an 8-month period, and provided laboratory reports to document HIV viral load. A subset engaged in qualitative interviews. We carried out descriptive quantitative analyses. Then, qualitative data were analyzed using directed content analysis. Data integration used the joint display method. Results: Participants (N = 80) were 49 years old, on average (SD = 9), and 75% were assigned male sex at birth. Most (79%) were African American/Black, and the remainder were Latino. Participants were diagnosed with HIV 20 years previously on average (SD = 9). Overall, components were feasible (>80% attended) and acceptability was satisfactory. A total of 39% (26/66) who provided laboratory reports at follow-up evidenced viral suppression. Findings suggested no components were entirely unsuccessful. The lottery prize compared to fixed compensation was the most promising component level. In qualitative analyses, all components were seen as beneficial to individual wellbeing. The lottery prize appeared more interesting and engaging than fixed compensation. However, structural barriers including financial hardship interfered with abilities to reach viral suppression. The integrated analyses yielded areas of convergence and discrepancy and qualitative findings added depth and context to the quantitative results. Conclusions: The virtual and/or low-touch behavioral intervention components tested are acceptable and feasible and show enough potential to warrant refinement and testing in future research, particularly the lottery prize. Results must be interpreted in the context of the COVID-19 pandemic. Trial registration: NCT04518241 (https://clinicaltrials.gov/ct2/show/NCT04518241).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Entrevista Motivacional / COVID-19 Tipo de estudio: Clinical_trials / Health_economic_evaluation / Qualitative_research Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Front Public Health Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Entrevista Motivacional / COVID-19 Tipo de estudio: Clinical_trials / Health_economic_evaluation / Qualitative_research Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Front Public Health Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza