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HIV/AIDS
Protocol
Telehealth and texting intervention to improve HIV care engagement, mental health and substance use outcomes in youth living with HIV: a pilot feasibility and acceptability study protocol
  1. Angie R Wootton1,
  2. Dominique A Legnitto1,
  3. Valerie A Gruber2,
  4. Carol Dawson-Rose3,
  5. Torsten B Neilands1,
  6. Mallory O Johnson1,
  7. Parya Saberi1
  1. 1 Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, California, USA
  2. 2 Department of Psychiatry, University of California, San Francisco, San Francisco, USA
  3. 3 School of Nursing, Department of Community Health Systems, University of California, San Francisco, San Francisco, California, USA
  1. Correspondence to Professor Parya Saberi; Parya.Saberi{at}ucsf.edu

Abstract

Introduction Youth and young adults living with HIV (YLWH) experience worse clinical outcomes than adults and high rates of behavioural health challenges that impact their engagement in care and adherence to antiretroviral therapy. This study in the San Francisco Bay area aims to evaluate the feasibility, acceptability and preliminary clinical outcomes of a 12-session telehealth counselling series provided to 80 YLWH, including education, motivational enhancement and problem-solving around HIV care, mental health, substance use and other challenges. Findings will provide information about benefits and challenges of telehealth counselling for YLWH and will guide the development of new technology-based strategies for care.

Methods and analysis The Youth to Telehealth and Text to Improve Engagement in Care study is a pilot randomised, crossover trial examining the feasibility and acceptability of a telehealth counselling intervention consisting of twelve 20–30 min weekly sessions focused on identifying and problem-solving around barriers to HIV care access and adherence and on addressing mental health, substance use and/or other issues. Participants also receive text messages for check-ins, appointment reminders and to improve engagement. Participants complete quantitative online surveys at baseline, 4 and 8 months and qualitative exit interviews. Clinical outcomes, including plasma HIV RNA and CD4+ cell count, are collected from medical records. Study staff will explore outcomes of the intervention using quantitative and qualitative methods.

Ethics and dissemination This study and its protocols have been approved by the University of California, San Francisco (UCSF) Institutional Review Board. Study staff will work with the UCSF Center for AIDS Prevention Studies’ Community Engagement Core and the Youth Advisory Panel to disseminate results to the community, participants and the academic community.

Trial registration NCT03681145.

  • HIV
  • antiretroviral therapy
  • mental health
  • substance use
  • counselling
  • telehealth
  • text messaging
  • young adults

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-028522

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    Footnotes

    • Contributors PS, CDR and MOJ conceived the study and developed the experimental design and measures. ARW and VAG developed the telehealth counselling intervention and manual. DAL and PS developed the main study protocols. ARW and DAL carried out the daily study activities. TBN contributed to the data collection and analysis plan. All authors were involved in the revision of the draft manuscript and have agreed to the final content.

    • Funding Research reported in this publication was supported by the California HIV/AIDS Research Program (CHRP) award number HD15-SF-060 (co-PIs Saberi and Dawson Rose) and the National Institutes of Health award number K24DA037034 (Johnson). The National Institutes of Health and Cancer Disparities Research Partnership have reviewed, approved and have no role in this study besides financial support.

    • Competing interests None declared.

    • Ethics approval University of California, San Francisco IRB # 16-18538.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Not required.