Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States.
Departments of Psychiatry and Pediatrics, University of California, San Francisco, San Francisco, CA, United States.
JMIR Mhealth Uhealth. 2020 Jan 10;8(1):e16838. doi: 10.2196/16838.
HIV continues to be a public health challenge adversely affecting youth and young adults, as they are the fastest-growing group of new HIV infections in the United States and the group with the poorest health outcomes among those living with HIV. HIV prevention science has turned to mobile health as a novel approach to reach and engage young people living with HIV (YPLWH) experiencing barriers to HIV care.
This study aimed to assess the feasibility and acceptability of a text message-based HIV care navigation intervention for YPLWH in San Francisco. Health eNavigation is a 6-month text message-based HIV care navigation where YPLWH are connected to their own HIV care navigator through text messaging to improve engagement in HIV primary care. Digital HIV care navigation included delivery of the following through SMS text messaging: (1) HIV care navigation, (2) health promotion and education, (3) motivational interviewing, and (4) social support.
We evaluated the feasibility and acceptability of a text message-based HIV care navigation intervention among YPLWH. We assessed feasibility using quantitative data for the overall sample (N=120) to describe participant text messaging activity during the intervention. Acceptability was assessed through semistructured, in-depth interviews with a subsample of 16 participants 12 months after enrollment. Interviews were audio-recorded, transcribed, and analyzed using grounded theory.
Overall, the text message-based HIV care navigation intervention was feasible and acceptable. The majority of participants exhibited medium or high levels of engagement (50/120 [41.7%] and 26/120 [21.7%], respectively). Of the majority of participants who were newly diagnosed with HIV, 63% (24/38) had medium to high engagement. Similarly, among those who were not newly diagnosed, 63% (52/82) had medium to high engagement. The majority of participants found that the intervention added value to their lives and improved their engagement in HIV care, medication adherence, and viral suppression.
Text message-based HIV care navigation is a potentially powerful tool that may help bridge the gaps for linkage and retention and improve overall engagement in HIV care for many YPLWH. Our results indicate that participation in text message-based HIV care navigation is both feasible and acceptable across pervasive structural barriers that would otherwise hinder intervention engagement.
艾滋病毒仍然是一个公共卫生挑战，对青年和年轻人产生不利影响，因为他们是美国新感染艾滋病毒人数增长最快的群体，也是感染艾滋病毒人群中健康状况最差的群体。艾滋病毒预防科学已经转向移动健康，作为一种新方法，以接触和吸引感染艾滋病毒的青年（YPLWH），他们在接受艾滋病毒护理方面存在障碍。
本研究旨在评估旧金山针对 YPLWH 的基于短信的艾滋病毒护理导航干预措施的可行性和可接受性。健康电子导航是一种基于 6 个月短信的艾滋病毒护理导航，通过短信将 YPLWH 与他们自己的艾滋病毒护理导航员联系起来，以改善他们对艾滋病毒初级保健的参与度。数字艾滋病毒护理导航包括通过短信文本消息传递以下内容：（1）艾滋病毒护理导航，（2）健康促进和教育，（3）动机访谈，和（4）社会支持。
我们评估了基于短信的艾滋病毒护理导航干预措施在 YPLWH 中的可行性和可接受性。我们使用总体样本（N=120）的定量数据来描述干预期间参与者的短信活动，以此来评估可行性。通过对 16 名参与者的半结构化深入访谈，在参与后 12 个月评估可接受性。访谈内容被录音、转录，并使用扎根理论进行分析。
总体而言，基于短信的艾滋病毒护理导航干预措施是可行和可接受的。大多数参与者表现出中高度的参与度（50/120 [41.7%]和 26/120 [21.7%]）。在新诊断出艾滋病毒的大多数参与者中，63%（24/38）的参与度为中高度。同样，在未新诊断出艾滋病毒的参与者中，63%（52/82）的参与度为中高度。大多数参与者认为该干预措施为他们的生活增添了价值，并改善了他们对艾滋病毒护理、药物依从性和病毒抑制的参与度。
基于短信的艾滋病毒护理导航是一种潜在的强大工具，它可以帮助弥合联系和保留方面的差距，并提高许多 YPLWH 对艾滋病毒护理的整体参与度。我们的结果表明，即使存在会阻碍干预措施参与的普遍结构性障碍，参与基于短信的艾滋病毒护理导航也是可行和可接受的。
