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Mobile and Connected Health Interventions to Improve Care Continuum and Health Outcomes among Youth with HIV

NAMHC Concept Clearance

Presenter:

Dianne Rausch, Ph.D.
Division of AIDS Research

Goal:

The goal of this initiative is to develop and test the next generation of interventions delivered through mobile health (mHealth) technology to improve testing, linkage to care, retention in care, and antiretroviral therapy (ART) medication adherence among youth living with human immunodeficiency virus (YLWH).

Rationale:

In 2015, 670,000 young people between the ages of 15 to 24 were newly infected with human immunodeficiency virus (HIV) globally. While the number of YLWH continues to rise, YLWH are not well served by the HIV care continuum. The most concerning outcome is that AIDS-related deaths among adolescents have increased over the past decade despite decreased death rates among all other age groups. Age-related disparities are evident at each step in the HIV care continuum. For example, it is estimated that less than half of U.S. HIV-infected youth are aware of their HIV status.

Interventions delivered through mHealth technology represent a promising approach for improving outcomes among YLWH. mHealth approaches use wireless devices and tools such as smartphones, text messaging, electronic pillboxes, and sensor devices to monitor health and deliver healthcare interventions. Recent work in this field uses the term “connected health” to denote the use of technology to deliver healthcare remotely. Youth are avid adopters and heavy users of smartphones and digital technologies, and these technologies offer opportunities to tailor interventions to developmental stages and personal needs. Importantly, these technologies may deliver interventions in real-time and in ecologic settings. This creates an opportunity to remotely reach YLWH through mHealth/connected health approaches to strengthen their HIV care continuum engagement and treatment outcomes.

Responsive research directions include, but are not limited to, the development and testing of:

  • Tools and technologies to increase the uptake of rapid home HIV self-testing and linking youth to care.
  • Novel remote treatment services to improve retention in HIV care for youth living with HIV, and to help re-engage youth who have fallen out of care.
  • Technologies to assist in the transition of youth from pediatric to adult care.
  • Technologies that rapidly link youth to HIV care after they test positive for HIV.