Individualized Texting to Reduce Disparities in HIV Care (iTAB-Disparities)
The primary hypothesis of Project 1 is that a two-way, text messaging intervention (iTAB) will help close the gap in ART adherence differences between AA and other HIV-infected persons receiving care at Family Health Centers of San Diego (FHCSD), the county’s largest provider of comprehensive HIV services. The specific aims are: 1) refine and tailor iTAB to improve ART adherence among HIV-infected AA receiving care at FHCSD and 2) implement iTAB for 48 weeks among 100 AA patients with the goal of improving rates of virologic suppression. To develop iTAB, we will conduct in-depth interviews (n=10), focus groups (2 groups of n=8), and pilot testing (n=5) of an existing text messaging intervention for ART adherence. After refinement, we will conduct a prospective, open label, single arm study to evaluate the change in ART adherence among 100 AA FHCSD clients receiving the tailored iTAB intervention for 48 weeks.
Our specific aims capitalize on our ability to quickly target one node of the HIV treatment cascade (i.e., ART adherence) by refining our established, theory-based intervention (individualized Texting for Adherence Building; iTAB) for use with AA clients at FHCSD. We propose a prospective, open label, single arm study to evaluate the change in ART adherence among 100 AA FHCSD clients receiving the tailored iTAB intervention. The iTAB intervention will be tailored to assess the needs of AA clients of FHCSD during an initial period (Aim 1), followed by implementation and evaluation of tailored iTAB to assess the efficacy of this personalized adherence intervention with 100 AA FHCSD clients (Aim 2). These two aims are responsive to the CHRP call to implement “innovative evidence-based interventions to reduce HIV disparities.”
Our overarching hypotheses are: 1) AAs are a subgroup of individuals living with HIV in San Diego who need adjunctive services to improve HIV care and treatment, 2) that iTAB can be honed for HIV-infected AAs, and 3) the tailored iTAB system will improve ART adherence and subsequently improve HIV disease among AA HIV-infected persons receiving care at FHCSD.