School of Nursing, Columbia University, 560 W 168th St, New York, NY, 10032, USA.
Clínica de Familia La Romana, La Romana, Dominican Republic.
BMC Public Health. 2024 Jan 17;24(1):201. doi: 10.1186/s12889-023-17538-y.
BACKGROUND: While there is no cure for HIV, adherence to antiretroviral therapy can extend the lifespan and improve the quality of life of people with HIV. Despite the global reduction of HIV infection rates in recent years, New York City and La Romana, Dominican Republic, continue to report high infection rates among Latino populations. Many people with HIV remain virally unsuppressed in these geographic hotspots, suggesting a need for additional interventions to overcome medication adherence barriers. Tailored and culturally appropriate mobile health (mHealth) technology can be an engaging way to improve adherence. The primary objective of this trial is to test the effectiveness of an mHealth tool to improve HIV medication adherence among Spanish-speaking people living in New York City and the Dominican Republic. METHODS: The WiseApp study is a two-arm randomized controlled trial among 248 people with HIV across the New York and Dominican Republic sites over the course of 12 months. Participants are randomly assigned to either receive a CleverCap pill bottle that is linked to the WiseApp (intervention) or standard of care (control). All participants complete surveys at baseline, 3-month, 6-month, and 12-month follow-up visits and the study team obtains HIV-1 viral load and CD4 count results through blood draw at each study timepoint. DISCUSSION: The use of mHealth technologies to improve medication adherence among people with HIV has been implemented in recent years. Although some studies have found improvement in adherence to antiretroviral therapy in the short term, there is limited information about how these interventions improve adherence among Spanish-speaking populations. Disproportionate rates of HIV infection among Latinos in New York City suggest an existing inequitable approach in reaching and treating this population. Due to a lack of mHealth studies with Latino populations, and apps tailored to Spanish-speakers, the WiseApp study will not only demonstrate the effectiveness of this particular mHealth app but will also contribute to the mHealth research community as a whole. TRIAL REGISTRATION: This trial was registered with Clinicaltrials.gov (NCT05398185) on 5/31/2022.
背景:虽然目前尚无治愈艾滋病的方法,但通过接受抗逆转录病毒治疗,可以延长艾滋病患者的寿命并改善其生活质量。尽管近年来全球艾滋病感染率有所下降,但纽约市和多米尼加共和国的拉罗马纳仍报告称,拉丁裔人群的感染率居高不下。在这些艾滋病高发地区,许多艾滋病患者的病毒仍未得到抑制,这表明需要采取额外的干预措施来克服药物依从性障碍。量身定制且文化适宜的移动医疗(mHealth)技术可能是一种提高依从性的有效方式。本试验的主要目的是测试一种 mHealth 工具在提高讲西班牙语的纽约市和多米尼加共和国居民对艾滋病药物的依从性方面的有效性。
方法:WiseApp 研究是一项为期 12 个月、在纽约和多米尼加共和国两个地点开展的 248 名艾滋病患者参与的双臂随机对照试验。参与者被随机分配至接受与 WiseApp 相关联的 CleverCap 药瓶(干预组)或标准护理(对照组)。所有参与者在基线、3 个月、6 个月和 12 个月的随访访问中完成调查,研究团队在每个研究时间点通过抽取血液获得 HIV-1 病毒载量和 CD4 计数结果。
讨论:近年来,移动医疗技术已被用于提高艾滋病患者的药物依从性。尽管一些研究发现短期接受抗逆转录病毒治疗可提高药物依从性,但关于这些干预措施如何提高讲西班牙语人群的药物依从性的信息有限。纽约市的拉丁裔人群中艾滋病感染率不成比例,这表明在接触和治疗这一人群方面存在不公平的方法。由于缺乏针对拉丁裔人群的移动医疗研究以及专为西班牙语使用者定制的应用程序,WiseApp 研究不仅将展示特定 mHealth 应用程序的有效性,还将为整个移动医疗研究界做出贡献。
试验注册:该试验于 2022 年 5 月 31 日在 Clinicaltrials.gov(NCT05398185)注册。
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