A Video-Based mHealth Program to Support People Living with HIV Across the HIV Care Continuum

PROJECT ABSTRACT This proposed Phase II SBIR project will finalize our Virtual Support System (VSS), a mobile health (mHealth), video-based system that provides support to young Black men who have sex with men (YBMSM) across the entire HIV care continuum. There are currently 1.2 million people living with HIV in the United States, and among MSM nationally, Black MSM had the highest number of HIV diagnoses in 2018. Engagement in care is often thought of as a continuum including 1) HIV diagnosis, 2) linkage to care, 3) retention in care, 4) HIV antiretroviral therapy (ART) initiation, and 5) viral suppression, and YBMSM experience severe disparities across the HIV care continuum, compared to both older Black MSM and young White and Latino MSM. Our VSS addresses multi-faceted challenges that lead to poor treatment initiation, adherence, and retention outcomes among YBMSM. It takes a holistic approach, tailored specifically for YBMSM, to improve well-being and reduce stigma through customizable video-based support, a community of peers, on-demand information, and access to local resources within a simple-to-follow user interface. Moreover, VSS fills a critical gap, as mHealth programs currently available to YBMSM living with HIV are few in number and typically narrow in scope. VSS will be free of cost for YBMSM and marketed to HIV organizations nationwide. Our Phase I findings demonstrated that VSS is highly acceptable, usable, and appealing to both YBMSM living with HIV and their service providers. We hypothesize that VSS, created using human-centered design, will improve HIV care continuum outcomes (as measured by viral suppression) and reduce stigma among YBMSM ages 18-29 who are living with HIV. This new intervention will also enhance the ability of HIV service organizations nationwide to ensure optimal HIV care for YBMSM clients, as VSS can be easily integrated into their existing linkage and case management services. Several HIV service organizations have expressed a need for VSS and will support the project as collaborators. There are three specific aims to our proposal. AIM 1: Complete development of the VSS and Provider Dashboard in collaboration with YBMSM living with HIV and Providers. AIM 2: Conduct an RCT with YBMSM living with HIV (n=264 at 5 sites) to assess impact on HIV care continuum and quality of life outcomes. AIM 3: Conduct a qualitative evaluation of VSS among HIV providers and YBMSM living with HIV. In Year 1, we will complete development of the VSS product and conduct usability testing and consultation of advisory boards of service providers and YBMSM living with HIV. Year 2 will involve a randomized control trial and a qualitative evaluation of VSS. Following Phase II, VSS will be ready to be marketed and rapidly deployed to HIV service providers and organizations throughout the U.S. to have rapid, wide-scale, and sustainable impact on HIV care outcomes for YBMSM.