Mhealth for Pre-exposure Prophylaxis Adherence by Young Adult MSM

AbstractEnvironment and Health GroupTufts HIV AIDS Clinicand the Boston area PrEP Community of Practice will collaborate under the leadership of Patricia WeitzmanPhDto develop and test the feasibility and short term effectiveness of the first ever individually tailoreddevelopmentallyand culturally sensitivemobilemhealthPrEP adherence toolIt will target culturally diverseyoung adult men ageswho have sex with menYMSMWhen PrEP is taken dailyit can reduce HIV risk by up toThe CDC estimates PrEP is appropriate forMSM in the U SImpact models show even modest PrEP adherence could reduce new HIV infections among MSM byoveryearsThe recent rise in HIV infection among young adults ageparticularly minority YMSMpoints to the value of PrEP uptake and adherence support for culturally diverse YMSMIn PrEP trialsyounger age was the most consistent correlate with low PrEP adherenceExtensive mobile phone penetration among young adults makes mhealth an ideallow cost method for providing PrEP adherence support to YMSMWe bring together a developmental understanding of young adult decision making with principles from social learning theory and positive psychology for supporting PrEP adherenceThe proposed project is based on DrWeitzmanandapos s successful Phaseand current Phaseanti retroviral therapyARTmhealth adherence intervention for HIVAfrican Americanswhich combined tailored pill reminders with ageand culturally sensitive motivational and educational textsExperts suggest building PrEP adherence interventions on proven ART adherence interventions as many PrEP adherence facilitators are the same as ARTMoreoverthe growing literature on mhealth shows it is a powerful approach to supporting adherence across conditionsIn addition to building on our prior ART mhealth toolwe address facilitators barriers identified in PrEP RCT follow up studiesand CDC PrEP adherence recommendationsMoreoverformative focus groups with diverse YMSM will allow us to identify and target unique adherence barriers and facilitators in this groupThe intervention will provide tailored pill reminders with PrEP education textsas well as developmentally sensitive motivational textsWe will include sleep hygiene and alcohol use messageswhich have direct relevance to young adultsBy using a low costaccessible mobile phone toolthe intervention eliminates several access barriers to supportwhich can be a particular problem for low income and minority patientsOur overarching goal is to help stop the rise in HIV among YMSM Project NarrativeThe proposed project involves the development and testing of an mhealth intervention to increase adherence to PrEP treatment using texts providing tailored pill remindersmotivational messagesand health education messagesThe intervention targets culturally diverse young adult men who have sex with menMSMwho are at high risk for both HIV and non adherence to PrEP medicationSupporting PrEP adherence in this group would reduce new HIV infections and related disparities