Youth to Text or Telehealth for Engagement in HIV Care (Y2TEC)

There is a strong association between younger age and less engagement in care, lower adherence, and increased risk of virologic failure. Additionally, problematic substance use and untreated mental health challenges frequently occur in youth living with HIV (YLWH) and disrupt the continuum of HIV care. In response to this public health dilemma, our research team proposes to assess the feasibility and acceptability of two delivery models (text messaging and videoconferencing) for improving engagement in HIV care and decreasing substance use and mental health challenges among YLWH (18-29 years of age). We aim to adapt existing interventions for YLWH and further develop these interventions to create the Youth to Text or Telehealth for Engagement in HIV Care (Y2TEC) intervention for improved engagement in care and reduced substance use and mental health challenges. If feasible and acceptable, it can be scaled up for a multi-site randomized clinical trial and ultimately offered in clinical care of YLWH.

Motivational interviewing and brief problem-solving interventions have been extensively examined in youth. Many studies have revealed significant reductions in alcohol and drug use as a result of motivational interviewing and problem-solving interventions. Although the evidence-base supporting integrated mental health, substance use, and HIV care adherence counseling is still developing, interventions combining the three aspects appear promising.

Our intervention, Y2TEC, will further the use of integrated behavioral health counseling, which has emerged as an important model for identifying and addressing substance use and mental health problems in medical settings. Given the close connection between engagement in HIV care, substance use, and mental health challenges, all three must be addressed concurrently. Therefore, our intervention is innovative because it will be one of the first integrated mental health and substance use problem-solving interventions centered around improving engagement in HIV care among YLWH.